HomeMy WebLinkAboutBuilding Permit 03-0204
CITY OF PRIOR LAKE
INSPECTION NOTIl:E
SCHEDULED
.'
ADDRESS
5$' .YO
r:-o,'r 10..." s:h_"
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
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COMMENTS:
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( ( ,1~
I UJ't.
DATE TIME
t;-(?
3 -)tXf
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
[:",.
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: vv(? 5 -f)rJJ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANce.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
(Please rype or print and sign at bottom)
ADDRESS
5590
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
PI11~n/V;J .J/IP~
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
~JC
(Phone)
BUILDER P' i._J ..d ~
(Name)~J' r Q/ f,/ Vd 0 s;:
(Contact Name)
(Address) 9~'?6 I{p/~,)f Giko
TYPE OF WORK
DMisc.
D New Construction
DDeck
(Phone)
(Phone)
1/1/f 11/
DPorch
ORe-Roofing
Date Rec'd
2., z,5" 'in......
~
.
I PERMIT NO. ()j' - D.t-/?#
ZONING (office use)
/e.t..rO
PID ZS-o:Jl- (j () 9-0
CIS? '-/b / 3(, db
/
)Re-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
authoflzed agent for the above-mennoned property and that all construcnon Will conform to all eXlstmg state and local laws and WIll proceed 10 accordance With
submitted Pla~s I ware that the tIding offiCial can revoke thIS permIt for Just cause Furthermore, I hereby agree that the CIty officIal or a deSignee may
enter upon the e, to perrm d mspecnons .,-
X ~r j/-<J 2.-2-S -D5
SIgnature 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
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
2, ~OO. 00
7..{.1J
--
~-
I.N
This Arz;;rmes Yom Building P~~it;;;ved
Building Official
Date
DAddition
DAlteration
# $
# $
$
$
# $
# $
$
$
$ 70 .d 0
I Recf)o. 9""..fW~
Bv I _ .
0
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
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid
I Date
~,
-r/(O . v
t., LA~'(JJ
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