HomeMy WebLinkAboutBuilding Permit 03-0953
DATE
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CITY OF PRIOR LAKE
INSPECTIO/'l NOTICE
SCHEDULED
ADDRESS
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
fh. ~4'~
COMMENTS:
TillE
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.-....-
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~~~
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /W Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
.....,.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
Date Rec'd
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
(Please tyPe or print and sien at bottom)
ADDRESS
t:),~45' L~e.\.\\bE \t\ Ll (LD
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
I. Z- t. 01
I PERMIT NO. Q3-0~53 I
ZONING (office use)
. 2!:>""1". UO:;". 0
PID7S ~.~ 0
~':~~(JM"-\ STES
(Address) S~ UW-~ AGE th LL f2.-b
~~~~R-fDD tJNE (})NS~0CJ10NMJD RoOrlNG (Phone) q~-g~I-~
(Contact Name) STe\lE (Phone)) ol;).-,~d(( -f?51.o1
(Address) daD Lu. qgiH SJ~.3f: SUII6 /g) tJ.rorvI/f\JG70tJ 93taO
(Phone)
TYPE OF WORK
o New Construction
DDeck
DPorch
~e.ROOfing
DAlteration
DLower Level Finish
o Fireplace
DAddition
..JMisc.
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
DUtility Connection
~ . c::fJ) -
I hereby certity that I have furnished information on this application which is to the best of my knowledge true and correct. I also certity 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
;terub~;rprinSpectiOns J{)~ \ 2S4-g3 7- :2 )- t7 J
. Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I Plumbing Permit Fee $
\ . Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
c /;r~. OJ
'1 u.o_?
This Application Becomes Your Building Permit When Approved
I Paid
I Date
Building Official
Date
# $ I
# $ I
$ I
$ I
# $ I
# $ I
$ I
$ I
h ifl? (/l) I
I Receipt 1P6. ~<f I
Bv J1..-. I
U
This is to cenify 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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372