HomeMy WebLinkAboutBUILDING 01-1288
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/4'670
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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DIJH I()
DATE TIME
SCHEDULED / . Zl, 09
/
ChJvI Oc6 W dV 0 t-H.
CONTR.
PERMIT NO.
01. Izr~
o PLUMBING RI
o MECH RI"
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
D COMPLAINT
D FIREPLACE RI
o FIREPLACE FINAL
D GASLINE AIR TST
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7716 PI 06
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
INS/iIOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. 01-/'2-88
/4-<J:70
6/}Noe-E WOOD L/-tll,c
LEGAL DESCRIPTION (office use only)
LOT
/ ADDITION
PID
BLOCK
/ I
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name)
(Contact Name) 1.,AyJ,/.( Z,r,
(Address) / a 7t/<;/1!hYil'
Date Rec' d
/ / /~' - /' I
ZONING (office use)
,J.-j
,-
/'"
(Phone); c>nJ (;'7:1 .4';1 ~l
\. ."
(Phone)
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
authorized agent for the above-mentioned property and that aU construction will conform to all existing state and local laws and wiIl proceed in accordance with
submitted plans, I am aware that the building official can revoke this permit for just cause, Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections,
-1./1 1 ,..,
X/Ii '1' , "
'I \' ' \-~- Signature
/ '
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TYPE OF WORK
o New Construction
OPorch
~e-ROOfing
o Alteration
ODeck
o Lower Level Finish
o Fireplace
OAddition
o Misc,
PROJECT COST/VALUE (excluding land) $
Contractor's License No,
1....--;
Permit Valuation
Permit Fee $
j
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
ReceiPt No.
By /
/l_
l I I ...___.---
,/ i----
Building Official
Date
ORe-Siding
OUtiIity Connection
/ /.,/'
, 'I ."),.,'J I
Date
$
$
$
$
$
$
$
$
$ .-
/
(
'.
'\.J
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 constirutes a temporary Certificate of Zoning compliance and allows consnuction to commence, Before occupancy, a Certificate of Occupancy must be
issued,
Planning Director
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