HomeMy WebLinkAboutBuilding Permit 03-0791
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS _lc~7~ J;/"/UJ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
L. 4 ;to,H7
A7Y Vl
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DATE TIllE
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o EXlGRADlFILLING
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 WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ 1-f{-D> Owner/Contr.
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1-=
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
: ~i~:' ~::y I PERMIT NO. /'l.'"J - 79/
3. Yellow Applicant I /.-:J
(Please ~e or Print and si2Il at bottom)
ADDRESS
\ S" .s '10 1.v;\~ .....o.~
I I
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
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LOT IJ BLOCK '")
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OWNER
(Name)
ADDITION
1-<< r
Jb...A.
t;l I'hed\()
(Phone) 9 ~ 1. ~ ~ L-j.., - 1. ~" 1
(Address)
BUILDER
(Name)
(Contact Name)
CIl.-~t:\-i.;:)Yi:'
b/<.- 9i, 1-.9110
(Phone)
(Phone)
41UU ~Av~Ltsl0lt b:Lv JJ.
",T.l.OTTIS pA~l[ MN 1;!';;tlR
ID #0001050
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(Address)
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TYFrF WORK
~ IJise. (\..:, "" VV-j
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o New constru?]n
DLower Level Finish
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certify that I have furnished information on this plication which is to the best of my knowledge true and correct. I also certify that I am the owner or
authori d agent for the above.mentioned property a at all construction will conform to all existing state and loear-Iaws and will proceed in accordance with
submitte s. I am aware that the buil . CIal can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;terupo P:~~~-'~"'""lS')\:spections \'150 JUN 1 22003
-0 Stgnatih\ Contractor's License No. Date
.e-Roofing
ODeck
DPorch
ORe-Siding
D Fireplace DAddition DAlteration
o'
PROJECTCOST/VALUE (excluding land) $ T~
DUtility Connection
...
I Permit Valuation
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
I Gas Fireplace Permit Fee
,.;2 500 I
7t1- 7<$' I
i d. ') I
I
I
I
I
I
I
Park Support Fee
SAC
$
$
$
$
$
$
$
$
$
#
#
$
$
$
$
$
$
$
$
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
arl67,I.IO
i~~ -- / f~ -/:)Y
#
#
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This Application Becomes Your Building Permit When Approved
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I ReceiptNo.
Bv
Paid
Date
Building Official
Date
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 nntice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372