HomeMy WebLinkAboutBUILDING 05-0745
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CITI'-OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBIN~GIN L
r;",ECH FINAL
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COMMENTS:
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL Fo/':EINSPECTION BEFORE COVERING
Inspector: ~,J. Owner/Contr:
. - - .
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
f, ;z. 00
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. 05. o7"'f5
(Please type or print and sign at bottom)
ADDRESS
_~"9.1 Wi /.;~ (} W 1:3&/){511 'M-.
ZONING (office use)
LEGAL DESCRlPTION (office use only)
LOT
BLOCK
ADDITION
PID25. loq. (.1(lZ.0
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
/CicEl!.J t;.7L. I4nJr/ Al6
,
(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ~je-ROOfing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connect:'
CODE: DI.R.C. DI.B.C. o Mise.
Type of Constnlction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A E: E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certiIY that I have hlrmshed mf"rmatllln 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 Il)r the
above-mentlOned property and that all cunstruction will conform to all existIng state and local laws and will proceed in accordance with submitted plans I am aware that the btllldmg
;IICial can :tr;;n;;:=-Furt~;;;;;:~hat the Clty official o:~a!J{JI :~n3/oq?:I1y to pertl)rm necde::;7i:3; 00
, I Signature Contractor's License No. Date
Sewer/Water Connection Fee
#
#
$ I
$ I
: ,e}
$ ~.
. JOA) -
/ ~~J2-t. ~ I
. Ill}' /' I
Vy 1
$ 1
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
Receipt No.
By
BlIIldmg Omcial
Date
ThiS IS to certify that the request in the above applicatIOn and accompanymg documents is 10 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
isslled.
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any