HomeMy WebLinkAboutBuilding Permit 04-0216
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
5. .z.3. of
ADDRESS
/~Z33 EVIi/JS/?JA! /tVb
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:
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DIJ 8" 10
4-.Z-i~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
rGASLlNE AIR TST
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(
7716 FI06
j /VA eT/VI 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/
INSJfIOn
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
; ~i~i~e ~::y I PERMIT NO. 0/./--'."']-/ / I
3 Vellow Applicant 7 CT k::J
(Please type or print and sign at bottom)
ADDRESS
/6}..g'5 fVhYlS~ 4~~ <::L
7r, O{l.t~\~ f . /1)/0
I
LEGAL DE1RIPTION tfice use only)
LOT ~~LOCK f ADDITION .,
OWNER 5Ln , M:.l,
(Name) ~ l'C,,\, ~~
~i VV) e..-
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
^-..
LGr"(1 h+-
J
(Phone)
(Phone)
(Phone)
o New Construction
ODeck
OPorch
ORe-Roofing
s-S 31;1..
ZONING (office use)
PID,;lS-oOI- o~-C
/ . '7 i /It:) ,a . '7
cl L'-'-If 7 (Jbl
OLower Level Finish
o Misc. I ~(2...C~1 ~O~
o Fireplace OAddition o Alteration
,.-.0
PROJECT COST IV ALUE (excluding land) $ / tJO(F---
~e-Siding
OUtility 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
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, 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 e J:l .perty?'~ e<1ed in.s~Ctions. i I L~ l ." -
X _ ~~ .~~__ ~ 7'/Z/UL(
~gnature Contractor's License No. . Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
fJ7/q, tJ 7J
4 /If.,/o ..,
I I
This Application Becomes Your Building Permit When Approved
~dID~ J/~j</
Paid
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ b~.oo
Receipt No.4" to 1:1
BY~.~
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
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372