HomeMy WebLinkAboutBuilding Permit 04-0358
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
5. 2.3. a%
ADDRESS
/ 4-723 G(;6N0/1~6 rt vt/
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:
~ '- OS r=; 771(5
DIJ e- I ()
~.3S'8
o EXIGRADIfILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ GASLlNE AIR TST
SIDINt3J'
/
F/u6
I /V ,,?} C!.4, V I 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.
INSJiIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~n at bottom)
ADDRESS
White
Pink
Yellow
I PERMIT NO. {)t.j - 3 s-gr
File
City
Applicant
/L/r;,)-3
~AdtJR-
(~
U/f'e-
ZONING (office use)
'c150
LEGAL DESCRIPTION (office use only)
LOTti BLOCK ~ ADDITION({}'WtL/fd
OWNER
(Name)
W6~Ne~
{
A
B'l-V'~ 'r\i. ~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
&L~-I~ ;;lAd
PID~-- 13~ -011-0
(Phone)
9 S- 2. - lj. V 7- 79 C) ()
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ~Re-Siding OLower Level Finish 0 Fireplace
OAddltion OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
II
F
1
III IV V A
HIM R
2 3 4 5
I
E
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby celtify that I have nlrnlshed mformatlOn 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 submllted plans I am aware that the buildmg
official can revoke this permit for Just cause Furthermore, I hereby agree that the City official or a deSignee may enter upon the propelty to perform needed mspectlllns.
x
~~~tu~
Permit Valuation dSO{). -I
Permit Fee $ /)/1 15 J
Plan Check Fee $ /"'a~ I
State Surcharge $ 1
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ I
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
Building Oflicial
Date
Contractor's License No.
0'/ -. l.ca - 0'-(
Date
$
$
$
$
$
$
$
$
$ 7C ..--
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
Paid
Date
.---
r /(;.. _
1.-/- dC-j -(}Gt
i Receipt No.l../~L/tj"l
I By /~
-0
ThiS IS to certIfY that the request in the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constitutes a temporaty Certificate of Zonmg compliance and allows construction to commence Before occupancy, a Certificate 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