HomeMy WebLinkAboutBUILDING 08-0365
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
.(;'1{(
C~S,:-t~
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
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COMMENTS:
DATE TIME
~.2 S--6(r
--.f- 3'-S-
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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ffiORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~R~>>LL FOR REINSPECTION BEFORE COVERING
Inspector: )/vp Owner/Contr: .
I
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
lNSNOTJ
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERnJ:f1CATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. Whi,e
2. Pink
) Yellow
File
City
Applicanl
ZONING (office use)
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(Please type or Drint and sign at bottom)
ADDRESS
~C111 en ss vt V\ t;{ trp\
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
(Phone)
BWDER Cd V\ fY fA C11V .
(Company Name) . ~~{ lv'\.~lj f:'Xl-e,y"lC~). LL(
(con. tact Name) ~i f\ SIV rJ Vl C\)( t1-VI
(Address) 1> ~ f?o X \v ld I f (flfv l.A \Lc
Date Rec'd
(0 tLVV
PERMIT NO.()8. 03(0 ~ i
PID
(Phone) q S L . 4 Lf 0 . (q 0 7
(Phone)
J
TYPE OF WORK 0 New Construction ODeck OPorch O!Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.c. PROJECT COST IV ALUE S 5~ D a. 0 0
Type of Construction: I II ill IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
. I hereby cemfy Ihat I have furnished information on Ihis application which is to the best of my knowledge true and correct. I also certify that J am the owner or authorized agent for lhe
above-mentioned property and that aU construction will conform to all existing Slate and local laws and will proceed in accordance with submitted plans. J am aware that the building
:mci~ can revo~~;\lr;qe) F~ore. I hereby agree that the ci~ official or U1 Oazn~er 50~e property ro perform necr; ("i7r;~
Signatdre . Contractor's License No. . Date:
I Permit ~aluation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
, Gas Fireplace Permit Fee
I
IS
I S
P
P
is
I S
I S
is
. Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
_/
I Paid / (9 - ./
I Date ,./t..dJ/'
Buildin!! Ollicinl
Date
# 1$
# i $
. $
I
, S
I
# . $
I
# i $
. $
I
i $
() is /~ ~ I
1iPtNO. .5~oZ "-
By / "'"
TIlls is to certify that the request in the: above application and accompanying documents is in accordance with the Ci~ Zoning Ordinance and may proceed as requested. This documcnI
when signed by the City Planner constitures a remporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
issued.
Planning DiIeclor
Date Special Conditions. ir any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372