HomeMy WebLinkAboutBuilding Permit 03-0847
DATE TIME ""'-",,\
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 7-J-bt
ADDRESS 17o~ WI ~</ V/-t"3>
OWNER CONTR.
PHONE NO. PERMIT NO. 1-~1
o FOOTING o PLUMBING RI o EXlGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~ULATI:Tc? d- O SEWER HOOKUP o FIREPLACE FINAL
FINAL 1: <.. o PLUMBING FINAL o GASLINE AIR TST
o SITE INSP CTlON o MECH FINAL 0
COMMENTS:
p-;VORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~LL FOR R:;:VCTlON BEFORE COVERING
Inspector: ? J- OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! .'.
ual<<>n
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~. 2- I, .03
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 03~O&+7 I
e or rint and si
at bottom
ZONING (office use)
kSc-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID~5-370 -Cl-f4~ 0
OWNER
(Name)
JON 10 1.
/J,' iO/tAN 0
(Phone) 95,;/- f/7"O -9'b 8 S'
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
DLower Level Finish
DAddition
ORe-Roofing
DAlteration
DRe.Siding
TYPE OF WORK
o New Construction
eck
DPorch
o Fireplace
o Utility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
I hereby certify that I have furnished information 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-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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the pro eta perform needed' ecti.ons.
d
Signatur
x
-
b
21::0$
Contractor's License No.
Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ 00
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 1/5, Z-~
This Application Becomes Your Building Permit When Approved
~'1~
Building Official
~~"/O 3
,
Date
Paid
Date
/15.20
to . z-c,. "-3
I~
-f4G7('
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
./
./ .
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /7078 {A/1l-LJEeAl6S' J' 7E.FI1 L-
TYPE OF WORK .D6e;c::
USE OF BUILDING ,eoS /IlK-.
PERMIT NO. 03~OB4-7 . DATE ISSUED 0.2&.03
BUILDER LO~NO PHONE# 4-+0 .~Sf3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR OATE
I FOOTING I ~ I 7/5'/0:5 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
__ I I I
I FINAL I r1# 17-P1-O> I
FOR ALL INSPECTIONS (952) 447-9850