HomeMy WebLinkAboutBuilding 08-0569
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~NSULATION 0 SEWER HOOKUP
~ ~INAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
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DATE TIME
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREaf'WeRtOCALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
CALl/447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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White
Pink
Yellow
File
Cily
Applicant
I PERMIT NO. og - S~ 11
(Please type or print and si~n at bottom)
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
)Name)
/ (Address)
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(Phone)
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BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ~e-ROOfing
/ OAddition OAlteration o Utility Conn(tlOn
CODE: 0I.R.C. OLB.C. 0 Mise.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(exduding land)
I
I
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I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I
I hereby certity that 1 have hlrnlShed mtlJrmation on this applical!on which IS to the best of my knowledge true and correct. I also certity that 1 am the owner or authorized agent for the
above-mentlOned property and that all cunstruction wIll conform to all eXlstmg state and local laws and will proceed In accordance with submated plans, I am aware that the buildmg
official can r> Jke tillS perma for Just cause Fut'thermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed mspectlons
7 0'J-.;""I. t .- ~ ~ } I J 0 "R
(;' (~~nature ~ Contractor's License No. Date
Gas Fireplace 'ermit Fee
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.'~'!.It.'" n B',"~'~<~" ;h! t~
. ,dIng UI'tlcial ~ Date .
ThIS IS to certlty ti11il''Il>.l:..xequest m the above appli l!on and accompanymg documents is 1Il accordance with the City Zoning Ordinance and may proceed as requested, TIllS document
when signed by the City~..".,,,:c,.. porary Certltleate of Zonmg cumpliance and allows ClJnstrucl!on to commence Before occupancy, a Certltlcate "fOccupancy must be
issucd
$
$
$
$
$
$
$
$
LL-C
I WaterMeter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
l TOTAL DUE
#
#
$
$
$
$
$
$
$
$
$
L(., - -
'2S-~.'
"1A. .'-1-<;"
Park Support Fee
SAC
#
#
...
Paid
Date
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., \ v
Receiot No. f J~u1
By (LJ) \K
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