HomeMy WebLinkAboutBUILDING 05-1070
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
341'7~ ~~~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING F~N
O~CH FINAL
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COMMENTS:
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L/&,,~~~
~-e / ~P7
DATE TIME
t>~~
~/~,
4~~ 7?1
.~~ - /~70
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO/>C;;~R.~INSPECTlON BEFORE COVERING
Inspector:. /~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
Pink
Yellow
File
City
Applicant
(Please type or print and si~n at bottom)
ADDRESS
I~/ L-
347&
W/f.,&~W ~greH
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
G0~{)
\,
(Phone)
Date Rec' d
10. z.S,'S'
PERMIT NO. O~ /07 ()
I
ZONING (office use)
PIDZS: IOh. O/~-' (J
Q~ ,""l t...J t\.u.A
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tieJ :I) "^^_
'-I ;;?~ 7
(Phone) 7 (} - 7'5 J --- ':--:. .f'\"
(Phone) _ (; II..- - 7/ Y.. z... - "S '7 C) Y (f:/I
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BUILDER
(Company Name)
(Contact Name)
(Address)
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l^-)ALJ I\H-~n
c+
ib2.SO
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r
TYPE OF WORK 0 New Construction OOeck OPorch XJie-Roofmg ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtiJity Connetri~n
CODE: DI.R.C. DI.B.c.
Type of Constnletion:
Occupancy Group: A II
Division:
o Misc.
I
E
II
F
1
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I heIL'by certify that I have hlrmshed brmatlOn 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
ahove-mentIOned property and tl1 aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans_ I am aware that the buildmg
ofliClal can revoke tillS -ml r Just ca'Jse urthermorc, I hereby agree that the Clty offiClal or a designee may enter upon the property to perform needed l1lSpectlons.
x
('")C. 7.0 'S<\(, TS? 4
Contractor's License No.
Permit Valuation
Park Support Fee
SAC
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
This Application Becomes Your Building Permit When Approved
7(,. -
/o.l,J7 cr-
Paid
Date
Iluildlllg Oflicial
Date
J vI t"S /0 .-
">
r D../tte
# $
# $
$
$
# $
# $
$
I $
I
I $ '7~. t7J
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Rec~ptlNo_ blJJ.1f
By V.
rr
ThiS IS tu certify that Ihe request 111 the above applicatlOn and accompanY1l1g documents IS in accordance with the City Zoning Ordinance and may proceed as requested. Tim document
when signed by the City Planner constllutcs a temporary Certificate of Zonmg compliance and allows constructIon to commence. Before occupancy, a Ccrtltkatc of Occupancy must be
L"iSlIl'd
Planning Director
Date
24 hOllr notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any