HomeMy WebLinkAboutBLDG 08-0616
DATE TIME
CITY OF PRIOR LAKE J~
INSPECTION NOTICE SCHEDULED
ADDRESS 4o'lf1 ~~aV\ _\<.0
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OWNER CONTR.
PHONE NO. PERMIT NO. 8- \o\LP
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~SULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
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~ WORK SA TISFVCTORY, PROCEE'D
/'6 CORRECT ACTION AND PROCEED
o CORREtJ)ORK. CALL FOR REINSPECTION BEFORE COVERING
In.,ectD't f'J OwoedConUc
~ALL ~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8. f4'~oP
I White
Pink
Yellow
File
City
Applicant
(Please type or print and siJln at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
BUILDER ___
(Company Name) .<. O~
(Contact Name) M('/~.~
I PERMIT NO.08, O(P / (p
ZONING (office use)
PID
~~
(Phone) 9sZ- 292. )-Z2 0
(Phone)
(Address)
?os5f-
1'1) tj ~r
A1A/
S~;,~
TYPE OF WORK 0 New Construction ODeck OPorch )t'Re-Roofing
OAddition OAlteration OUtility Conrtkm
o Misc.
ORe-Siding OLower Level Finish
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S U
PROJECT COST /V ALUE $
(excluding land)
I
E
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 COlTec!. I also certIfy that I am the owner or authOrIzed agent for the
above-mentIOned property and that all construction will conform to all eXistIng state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
official can revoke thiS perml! for Just cause Furthermore. I hereby agree that the CIty official or a deSignee may enter upon the property to perform needed InspectIons.
X ~~ --ZOO77/2-Cf 8'/1'1/0%
Signature Contractor's'License No. . Da&
Permit Valuation
Park Support Fee
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
SAC
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
tCr - J
V, tf-qV
Paid
Date
13uildlllg Ollicial
Date
# $
# $
$
$
# $
# $
$
I $
/) I $ 7'
~(;5(. 0
R1NO
By"'-
ThiS IS to certify 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 City Planner constItutes a temporary Certificate of Zonmg complIance and allows construction to commence. Before occupancy I a Certlficate of Occupancy mllst 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