HomeMy WebLinkAboutBuilding Permit 04-0603
DATE TillE
CITY OF PRIOR LAKE
INSPECnON NOTICE
SCHEDULED
6:Z3,dY
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
+-, '43
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/fIWNG
o COMPLAINT-
o FIREPLACE Rl
o FIREPLACE FINAL
.~ -2 GASUNE AIR TST
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COMMENTS:
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7716 PI u6
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I.
_ 0 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 INSPEcnON 24 HOURS IN ADV.~J"I:.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
IItSiioTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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White
Pink
Yellow
File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS
2!:J & '7 S fP/?-1 ~ G
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LEGAL DESCRIPTION (office use only)
LOT G BLoCK ADDITION
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OWNER
(N ame)
(Phone)
(Address)
Date Rec' d
C, .1 b. u tf-
I PERMIT NO. O~. 0 c:, Or
ZONING (office use)
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PID Zs-. IJ/ OOfe., 0
BUILDER . -'I) . f) L'
(Company Name) JD)0.1"J.sll O()rlU/~
(Contact Name) F/'/Vie: /1/clt,{,./Jr.} (Phone) 6C;-1' 7'7S-'-'62;1-0
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(Phone) _t}i;- (,'s 7 - 7t)$.f6:
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch ~ROofing
OAddition OAlteration OUtility Connion 0 Mise.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group:
Division:
ORe-Siding OLower Level Finish
o Fireplace
A
I
E
III IV
H I
2 3
B
S U
PROJECT COST /V ALUE $
(excluding land)
V
M
4
A
R
5
B
II
F
I
I hereby certifY that I have hlrnished mformation on this application which IS to the best of my knowledge true and COlTect. I also certifY that I am the owner or authonzed agent for the
Jbove-mentlOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. 1 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 property to perform needed mspectlllns.
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Signature Contractor's License No. Date
Permit Valuation
Park Support Fee
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit 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
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Paid
Date
Buildlllg Ofticial
Date
# $
# $
$
$
# $
# $
$
I $
I $
;1
ReceiPtft>(o.
By --1 /'
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ThIS IS to certify that the request in the above applical10n and accompanY1Og documents is 10 accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner constItutes a temporary 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