HomeMy WebLinkAboutBUILDING 05-1220
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL /
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
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SCHEDULED
CONTR.
PERMIT NO.
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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~ORK ~I:A r.-rORy,PROCEED~_u._-"""'---'
/ D~RRECT ACTION AND PROCEED
o CORRECT W?~~~ REINSPECTION BEFORE COVERING
Inspector: /r~ Owner/Contr:
.,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIIOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White
Pink
Yellow
File
City
Applicant
PERMIT NO. "
(Please tvpe or print and si~ at bottom)
ADDRESS
S (; if rv'"'1 J IJ ",I i " (',7 A ~;! ff r::.or
ZONING (office use)
LOT /'" BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION /
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OWNER
(Name) G1 r: E f(
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(Phone) 'l':;'.:J ~ -:;? .::J - S :; S'. (-:
(Address)l:)C l{ (/ h~ I Au) '.; ~ (I'''' i' c: f
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BUILDER 1 J ,I
(Company Name) \ Cl ',.., }/'?\'\-l'" J....,
(ContactName) r::(l;Ff\~1 ll\/,([
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(Address) 5.5 / J ' ,,-:';"\k. L.. ~.
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(Phone) -)!o -; < .::: 1 7-") 7 L.f ,~
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TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing ~Re-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c, o Mise.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ 1(, . "7/ c::;-:::5:-
Occupancy Group: A B E F H I M R S U .,
Division: 1 2 3 4 5 (excluding land)
I hereby certifY that I have filrnished mformation 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
abovc,.mentlOned pro~erty and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am awarc that the buildmg
ot11cial c.'a.n}evo~e t~~ ~~9\i., fi.for J.ust caus.e Ftl1]th~ 'more, I h el.'Tby..a gree that the CIty official or a deSignee. may enter upo..n.. the p.ropelty to perform need ed ms.pcctlons
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'Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit F(je
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter SizeS/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Applic'ltion Becomes Your Building Permit When Approved
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I:luildlllg Omcial'
Paid '-.1 (
Date r'
..
Receipt No. '-::' r/~
By r ,\i ~ .
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Datc
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 conslltutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
issued
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