HomeMy WebLinkAboutBuilding 08-0657
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS .) ~L( II
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
piNAL
o SITE INSPECTI~
COMMENTS: ~
- {
( '.1 /lL,/(
.......... \.'" ,
DATE
SCHEDULED ~ TIME
~l'Ql~) ~ t7Z
CON;. t
PERMIT NO.
oS - (,,,7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~l
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
^. -
II) ,,(
_ TVLL ~(, y:::;
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRr7f~L FOR REINSPECTION BEFORE COVERING
Inspecto! i r ./) Owner/Contr:
CA ~L 44~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
PERMIT NO. Of!;. O(P 57
(Please tvoe or ~rint and sign at bottom)
ADDRESS
/SY'//
Z3~6~ZY I'A/;";r-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) (:;AL.r; 0"-'1 ~ J#~ A.'l~~
t I
Ch~"'; ~A-'
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Pro
Date Rec' d
S. 2.2... OS
ZONING (office use)
?f..J. - ~Y7- tf"b ~ I
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition OAlteration o Utility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occnpancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have hlrmshed mt(,rmatllln on this applicatIOn which is lOthe best of my knowledge true and correct. I also certIfY that I am the owner or authOrIzed agent for the
above-mentIOned property and that all cllOstruction will conform to all eXlst10g state and local laws and will proceed in accordance with submitted plans. I am aware that the build10g
official can revoke thIs permIt for cause Furt~rmore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed inspectIOns
>It 0 -r - p/~.;Otl'
Signature Contractor's License No. Date
1/
[(;Receipt No. r)-( C 4D
,)5'
x
Permit Valuation -I
Permit Fee I $
Plan Check Fee I $
State Surcharge I $
Penalty I $
Plumbing Permit Fee I $
Mechanical Permit Fee I $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid 7(,- ((-
Date [i 2- Z (. D
Buildlllg Olliclal
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ 7(,.00
ThIS IS to certIfy that the request 10 the ablwe applIcatIon and aecompanY1Og documents tS 10 accordance with the City loning Ordinance and may proceed as requested. TIllS document
when signed by the City Planner constItutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertIficate ofOcclIpancy must be
isslIed
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, ir any