HomeMy WebLinkAboutBUILDING 01-1006
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
DATE TIME
s: 7. 0,(
1(,354- F~N~I tJ 7"h{".
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
0/. (06"
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o J4 f'u;, - /
-"::7.1'/01'1
e..t-OS r=; 7716 PI 06 ..
DIJ6 If) I/VAeTIVI TV
/
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 & SAFETY/
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1-/3 -0 I
(Please type or print and sign at bottom)
ADDRESS
I. White File
2. Pink City
3. y.llow Applicant
1~3:.;4- ~fI/~/AI m/l1L-
LEGAL DESCRIPTION (office use only)
LOT q BLOCK / ADDITION 8eO(Jt:~S.VIUE HILt..-S 2I\JD
OWNER
(Name)
B k-~() ,/1./5
.........-:-)
'- ell,
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
o New Construction
DDeck
PID 25'6,t&;.-{)09-0
~"'; ;. .5 ~.)3
447- 5052-
(Phone)
(Phone)
(Phone)
DPorch
,
p{Re-ROOfing
DAlteration
l~e-Siding
DUtility Connection
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
authori 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
sub tted lans. 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
rer upo the property to perf7\~~~ded inspections.
(X,,=:.-.. tl ~ < /n ~~..-/l~ '7 ~/ -S " d I
/ ././ - Signature
V
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
DLower Level Finish
o Fireplace
PROJECT COST/VALUE (excluding land) $
DAddition
r/
?I 60(). 001
$ , ?4.75 I
$ I
$
$
$
$
$
$
/.25
This AP/~~~ ~~~ding Permit When Approved
.JV~ CLJ3'O/
Building Official
Date
Contractor's License No.
Park Support Fee
SAC
#
Date
$
$
$
$
$
$
$
$
$ 1~.6 D
~;ej& 4c$7+-
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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
#
I Water Meter Size 5/8"; I";
I Pressure Reducer
Sewer/Water Connection Fee
#
#
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid
I Date
'l&. (;IV
,t?-/?-O ./