HomeMy WebLinkAboutBuilding 08-0745
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4~7IJ ~~
J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~NSULA TION 0 SEWER HOOKUP
~~INAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ 100\=
/ J I)
~' /;-./ 0 --f/f.. J
\-/ V~ J
"
DATE TIME
f,/Z'Ik
I
!5 ,.- ~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
() .
~..- ~~
- ........
-
rJ" ~~
~cd
/)/ .
f{ ~-f D.'S
v
.i WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W&RK. CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
While
Pink
Yellow
File
City
Applicant
PERMIT NO. 0 ~ ~ D 74-5
(Please type or print and sijtn at bottom)
ADDRESS
4'70
86rJ~
~/
.-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER . ~ - J
(Company Name) .//J"~S I Cht:r'LJ? ./?if,b CI' j~ Tnt"
(Contact Name) ,)"'!Uz.fJ.. .r:- t11"'rr~l/ _
(Address) ~.~41~ //67;a if ))'-Li!!J.k (}//~(<
Date Rec' d
CJ.If&>,OfJ
ZONING (office use)
(Phone) 9"7',2 -,m8'''' 7.cf~~)
(Phone)
/YJ kJ . ,J~-,~t'ldq
_ 7 {
TYPE OF WORK 0 New Construction ODeck OPorch "litRe-ROOfing
DAddition DAlteration DUtility Conn~n
DMisc.
ORe-Siding OLower Level Finish
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group:
Division:
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S
I
E
u
PROJECT COST IV ALUE $
(excluding land)
A
B
o Fireplace
I hereby certifY that I have furnIshed mformatlOn on this application which IS to the 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 construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildIng
otf1cial can revoke thIS permit for Just cause Furthermore. I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlons
C)~
fl
1/
~iPI No. _ <;7. t-3Z-
x
...
Signature
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
7/, -)
?'- I ~. ~'J"
Paid
Date
Buildlllg Ofticial
Date
<j-/~ .. /"' V
Date
$
$
$
$
$
$
$
$
$7fe
ThIS IS to certifY that the request m the above application and accompanYIng documents is in accordance with the City Zoning 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 of Occupancy 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, if any