HomeMy WebLinkAboutBUILDING 08-0424
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5J 0(
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
Cit)'{ -
COMMENTS:
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DATE TIME
7-~~{);Y
~.- L.jL '7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WDJK. CYOR REINSPECTION BEFORE COVERING
Inspector: J / L4 Owner/Contr:
v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
1 White
Pink
Yellow
File
City
Applicant
65 J C; {\1tweS
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(N ame)
(Address)
i BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck o Porch ~e-ROOfing
OAdditlOn OAlteration o Utility connecrn
CODE: OLR.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
Date !tee \ d
1~ I~ Of
I PERMIT NO. 0,. 0 4--Z-- ~ I
ZONING (office lIse)
PID
(tAt)
',,7-6' ~i -j / J C
OLower Level FinIsh
o Fireplace
$
$
$
$
$
$
$
$
Park Support Fee
SAC
PROJECT COST IV ALUE
(excluding land)
$
I hcrcl:ry certify that J have hlflllShcd mformatlOn no this application which IS to the best of my knowledge true and correct. I also certify that 1 am the owncr t)r authOrized agent for the
ahllv('.mentll1ned property and that all constructllJn Will con!i)rm to all eXlStmg state and local laws and will proceed 10 accordance with suhmltted plans I am aware that the hlllldmg
nffkial can revoke thIS permit .0.!JJ1'iLsallsc Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the propel1y to perform needed Inspections
X ' ~~~~:/=::- /<:.=____ _ -;;> / /c:(,~
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
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(9 -
"'l 1_ ()/)
llulld11l~ Urticial
Date
# $
# $
$
$
# $
# $
$
$
RLN:
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ThiS Is to certify that the' request 1Il the above application and accompanymg documents is 1Il accordance ~!ith the City Zoning Ordinance and may prDceed ,1S requested ThiS dllCllment
when signed by the City Planner constItutes a temporary Ccrtificate uf Zonmg compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
issllcd
Planning Director
Date
2.. hour notice for all inspections (1)52) ....7-9850. fax (952) ....7-..2..5
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any