HomeMy WebLinkAboutBuilding 08-0444
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
PiNAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
DATE TIME
7 - /(J-GJ6
X'" 44((
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND ~CEED
o CORRECT wo,(kAAJLFOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
/
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY O~ fRlOR LAKE BUILDINC PERMIT,
TEMPORARY CERTLFLCA TE OF ZONING COlVIPL.lANCE
AND UTILITY CONNECTION PERMIT
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Pink
Yellow
File
City
Applicant
(Please type or print and si~n at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
i BUILDER
(Company Name)
(Contact Name)
CL/e? fq I'~. e.- " C tJ'l '; tr I/C // to';
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(Phone) (' t, S /) .)-0 '7' -r /' '2' r:;,
(Phone)
(Address)
a'7
7 ~'
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PERMIT NO. 06, 0444-
ZONING (office use)
PID
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finrsh 0 Fireplace
OAddItlOn OAlteration o Utility ConnectIOn
CODE: DI.R.C. DI.B.c. o Mise.
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby ccrtity that I have turnished Information on this application which IS to the best of my knowledge trllC and COlTect I also certIfy that I am the owner or illlthor!zed agent for the
JbnvC-mCl1tlOllcd property and that all constructIOn will conform to allexistmg state and local laws and will proceed in accordance with submitted plans I am aware that the building
lllflnal can revllke tlm permll tiJr Just cause Furthermore, I hereby agree that the CIty olflcial or a deSignee may enter upon the propetty to perti)rm needed mspectlllns
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Sign;thjre-'"
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Contractor's License No.
Permit Valuation
Park Support Fee
SAC
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechal11cal Permit Fee I $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
Paid
Date
'7(. ,--
-: - '1. oy
Ilurldlllg Uniclal
Date
7 /7 /o~
Date
# $
# $
$
$
# ! $
# $
$
$
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I I ____. /-
Recei1t N/:J. b '" J O,.-lco
By I
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ThIS IS to certify that tl1e request 111 tht' above application and accompanying documents is In accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
v"hen signed by the CIty Pl.lnncr consututes a tempurary Certificate of ZOllmg complIance and allows constructton to commence Before occupancy, a CefttfiClltC llt" Occupancy must be
isslled
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