HomeMy WebLinkAboutBUILDING 01-0182
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4290 6~//IINOOO
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
o FINAL
[J SITE INSPECTION
o PLUMBING RI
o MECH R1"
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(!;, t- OS 6 7716
DIJ f5" I 0
DATE TIME
5. 7, ocr
01. 0 f~Z-
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AI$ TST
Ib1 p'/)(Je/
r'V.... . I flOe
PI 06
j /V ~ C!..4/VI TV
I
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 REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
~'".t~/"
I PERMIT N<>'.~\:rj'-O/0z.--
.,-, ZONING (offi,,"",
jelSD
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
4290 Ger1//\/WOO.D
White File
Pink City
Yellow Applicant
LEGAL DESCRIPTION (office use only)
LOT
ADDITION 612fllNNOOD fltR-i:::-
BLOCK
Date Rec' d
::3 ~/9-0 /
.'
PID 25 -03+ - DOe rC)
~~~~)~fI-.ESi/);Vl- 6-V/,<. (Phone) (-5/- 30 'j-fy,qr;
;
(Address) q2 IS '/3~~ 51, 5, ca?Je>..S<: C-POIw!-f H 10. Lt;'/) 01 ~
"
?'Re.siding
DUtility Connection
OWNER
(Name)
(Phone)
(Address)
TYPE OF WORK
o New Construction
. .
~e-Roofing
DAlteration
DDeck
DPorch
DLower Level Finish
o Fireplace
DAddition
o Misc.
PROJECT COST/VALUE (excluding land) $
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 all construction will conform to all existing state and local laws and will 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
:"'" un' P'O;;'Z;;:);/ t-M c' t, l"i <.0<1 (
--f ~~ -" - Co"",ctm', L,~"~ No . 4
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I This is to certify Ihat the request in Ihe above application and accompanying documents is in accordance with Ihe City Zoning Ordinance and may proceed as requested, This docu ment
when signed by Ihe City Planner constitules a lemporary Certificate of Zoning compliance and allows construction to commence, Before occupancy. a Certificate of Occupancy must be
issued,
I Permit Fee $ '74-. '1~
I Plan Check Fee $
I State Surcharge $ /'ZC;-
I Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
.-J.Sewer & Water Permit Fee $
I 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
This Application Becomes Your Building Permit When Approved
TOTAL DUE
Building Official
Paid
Date
7&.00
3,-/f.()/
Date
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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