HomeMy WebLinkAboutBUILDING 05-1109
DATE
d~M,
/
S~;7S- '-- \Zve . fr /
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
........trRNAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
';!ECH FINAL ()
~eyo() +
/7 J
/': G-,n." /..e S e:;>' ~/) ~ ""'/
~ r/l4../-.r __ R ~ ~
da~c-h~
~(7
~f {6t;/{ s
+m)'Yl . -/h-e
!()
/~
/
/
CJ'c;od
. , /~;-t d.-
V
TIME
,
-S"--//{)9
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
J /
4~ 0Ad ~
~~
r']
!/
'---
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
,
/
~ALL 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
1. While File
2. Pink City
) Yellow AppliCflnt
(Please tTW or orint and sicn at bottom)
ADDRESS
SLjCj 5 SJ1Vr€!- '-rr/~)
LOT
BLOCK
LEGAL DESCR.u- l.lON (office use only)
ADDITION
Date Rec' d
If. 4.a>
PERMIT NO. 05'. /1 (!) q
ZONING (office use)
PID zS: 040. 025. 0
(Phone) 7' S d- - Lf-9b- ;l'fSf-
Pnj;r ~ JnIV ~r 3"7;}-
BUll.DER 1\ I _ Ui'- :J.I>Db[)LfCt'f - C/VPLj ~f:. - )
(Company Name) Dl-ti'l vv~ {;,xf~ trr'S . (phone) /b3 7S'I-Od-d-7
(Contact Name) -J [) Ml (;; e -5) er (Phone) 7 b 3/7 Rt..( - LJ d-d- 7
(Address) / 3 D 5 - I f} L/ #t In 1// E :R )AA /1.L /J7 A..) S-S ~ 3 ~/
OWNER
(Name)
Jam L!:;:
(Address)
.5"1f15
.J- ~D/5'
Shpr~
W /// e..-tfe.-
Tr .ru)
-
TYPE OF WORK 0 New Construction
DAddition DAlteration
DLower Level Fimsh 0 Fireplace
h/OO~
CODE: OI.R.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
IDlY
H I
2 3
V A
M R
4 S
B
S U
PROJECT COST IV ALUE S
(excluding land)
x
\ Permit Valuation
\ Pennit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Pennit Fee
I Mechanical Pennit Fee
I Sewer & Water Pennit Fee
I Gas Fireplace Pennit Fee
J) - -;)- - [J)-
Date
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
I hereby certify that I havt 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
abovt-mentlOned property and that aU constroction will conform to all existing state and local laws and will proceed in accordance with submitled plans. 1 am aware that the building
ollicial can revolce this permit for just cause, Furthermore, I hereby agree that the city ollicial or a designee may enter upon the r--r-..J to perform needed mspcctions.
~ Si~ d-ODhDLfO;LI
Contractor's License No.
r Paid
I Date
7(,
II. 0+,05"
This Application Becomes Your Building Pennit When Approved
Building Ollicinl
Date
#
#
$
$
$
$
I $
1$
$
$
$ 7(p.OcJ
#
#
\ ReceiSlt No. S(;3I;.5"
BY7#
()
ThIS IS to certify that the reque'st in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requc'5tcd. This document
when signcd 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
PI81UUng Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 4474245
. 16200 Eagle Creek Avenue Prior Lake. MN 55372 .
(-r~o_<< i7D73 fUd~ j}y, Prfpyl~ 553?;)-)