HomeMy WebLinkAboutBuilding Permit 03-0561
DATE TIME
CITY OF PRIOR LAKE t ~ J1..
INSPECTION NOTICE SCHEDULED
ADDRESS LJ171.1 {?1"J W\,.,-
OWNER CONTR.
PHONE NO. PERMIT NO. S-SC I
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: r.e. rdo-r-
~ I
( ~) j ~C
f;~
~ORK SATISFACTORY, PROCEEO
o CORRECT ACTION AND PROCEEO
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~;vfl C -I};lfl; Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY/
U<SNDT/
(Please tvee or print and sUm. at bottom)
ADDRESS
437~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
S, /2- . OJ
I. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO'Q:?_OS~ II
~0 e:;q J /ltVT .sr.
ZONING (office use)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER r:-
(Name) rY4Iz k
(Address)
BUILDER
(Name).
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
L..:-/ j,.j VV
/
o New Construction
DLower Level Finish
PID z.s - on5 - 005, 0
(Phone)
(tin) tl1/0-6 7d,f
(Phone)
(Phone)
ODeck
o Fireplace
/
X~e-ROOfing
DAlteration
ORe-Siding
DUtility Connection
DPorch
PROJECT COST IV ALUE (excluding land) $
OAddition
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 property to perform needed inspections.
X _:l(~ ~,>';t-- S--/Z--03
SignatuJt"" Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
\ Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
?,SOO,O 0
$ 1c.f.7~
$
$ J_ W
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee # $
SAC # $
I Water Meter Size 5/8"; I"; $
I Pressure Reducer $
I City SAC and WAC # $
I Water Tower Fee # $
I Builder's Deposit $
I Other $
I TOTAL DUE $ 7&.00
/
I Paid '76.w IRe~o. ~I
I Date oS:. /'Z . (i 7 Bv _'
'" ()
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372