HomeMy WebLinkAboutBuilding Permit 03-0560
CITY OF PRIOR LAKE
INSPECTION NOTICE,
SCHEDULED
ADDRESS
{-Aoo (.ltdl t (t l~ f1A;)
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUNlBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Ie - ,C>>P
DA. TE TIME
;;-~((;
1-0'(;0
o EXIGRAD/FILLlNG
o CONlPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/ I rY f; Lt
(/
z(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InspectOr: 1111' y{C-O? _ OwnerlConlr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INS/'IOTJ
-.-...--.......-.-..---.".-
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sien at bottom)
I ADDRESS -f9tJO VteO/T ,€/f/6)e.
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
\\~" \
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
\'I\()f' \ ~ r
o New Construction
ODeck
Date Rec' d
5, /2, 03
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 03 --05~ 0 I
,eo .:5 e:
(Phone)
(Phone)
(Phone)
ZONING (ollic;use)
leZ-
PID25-0(j1- OOS-O ,
q ');) . ;:};::)0 -L..j,:);)- J
DPorch
t9A1?A,<:;~
~e-ROOfing
DAlteration
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
ORe.Siding
DUtility Connection
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
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
SIgnature
/J ~4 __--.q.
- I l"J (
"Z/500.00 I
$ 74-.75" I
$ I
$ I. z-5' I
$ 1
$ I
$ I
$ I
$ 1
This Application Becomes Your Building Permit When Approved
Building Official
Date
~
Contractor's License No.
#
#
#
#
I)
I ReceiJlfNo.
By- .J-.
U
L)~,J /a.~
'Date 1
$
$
$
$
$
$
$
$
$ 7~.O()
-M"U (,/
TItis 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
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
\ Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
Paid
Date
/'/.f?(/ [)
,';;- /7~_Of
Date Special Conditions, if any
24 bour notice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372