HomeMy WebLinkAboutBuilding 08-0563
DATE TIME
CITY OF PRIOR LAKE ,t
INSPECTION NOTICE SCHEDULED 8j 2~/~
ADDRESS I(/)~~;P~ (J'J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
8-~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
0. -
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- ,
II
A.f) ~f ~
I . I
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORtlEC1$K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: /1 . ~" Owner/Contr:
C {t/447-9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C~N1:SARE FOR YOUR PERSONAL HEALTH & SAFE;'
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date RecJl
1..$/.,11'
White
Pink
Yellow
File
City
Applicant
(Please type or print and si~ at bottom)
ADDRESS
16375 rnn~~ hi/ 52:; ~Oy /U'~. ./UAl553:r'J...
. , ~ 1
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
\ PERMIT NO. OS., o.5/e,3
ZON~G (office use)
PID
OWNER
(Name)
(odd CUAd L, ff'~
FYzr"Z.t e,r
(Phone) ~52) YYO-2lf I J..
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch )l5.Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn o Alteration OUtility Conne~n
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise
I
E
II
F
1
III IV V
HIM
2 3 4
A
R
5
B
S U
PROJECT COST /V ALUE $
(excluding land)
-
I hereby certity that I have hlrmshed mformal1on 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-menl1oned property and that all constructIon will conflJlm to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
OtfiCla~Can rev(~~per~u7 Fu;thelmOle, I heleby agree that the CIty offiCIal or a deSignee may enter upon the propelty to perform needed mspe:lons_
X _:ff'-~ f1!r. ~ :;-:>/ ZOt71J"
- v /- , ~ - Signature Contractor's License No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penahy $
Plumbing Permit Fee $
Mechanical Permit Fee $
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
Date
1& ,vV ;
.., ~'''V
, -
Buildlllg Omclal
Date
# $
# $
$
$
# $
# $
$
/}$
/ / $ 1'.,,(/1)
/ / ~_-t
Rtteipt No. ::Jc,,;7 f J
C'
ThIS IS to eertlty that the request m the above applicatIOn and accompanymg documents IS m accordance WIth the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the Cay Planner constltutes a temporary CertIficate of Zonmg compliance and allows construCl1on to commence. Before occupancy, a CertIficate of Occupancy must be
issued
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