HomeMy WebLinkAboutBuilding Permit 04-0824
CITY .OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/57// SK/ve-I/JE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
[] FINAL
[] SITE INSPECTION
[] PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
COMMENTS:
DATE TIME
5 / z~. or
-f, 824-
[] EXIGRADIFILLING
[] COMPLAINT.
[] FIREPLACE RI
[] FIREPLACE FINAL
.[] GASUNE AIR TST
[] ..s I DI fJ 6r
I
(!., t.- OS r=;
DIJH In
7716 Pt u6
//V~e.,:rIVlrv
I.
[] WORK SATISFACTORY, PROCEED
[] CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
~ALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cI: SAFETYI
IN$iton
(Please type or print and si~ at bottom)
ADDRESS
/57/ /
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
Pink
] Yellow
File
City
Applicant
sq L-I AI b
/fV~. N W
LEGAL DESCRIPTION (office use only)
VIG>V /JT
LOT 2-BLOCK 4- ADDITION Irt-~o
OWNER
(Name) M A /7 J/c"~;
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
()f;>l e9'O
/
Date Rec' d
B. (P.04--
PERMITNO.tJ~. oez~
ZONING (office use)
leI J' 0
PID 2S"". 1f".:J. 0 ~ 0, 0
(Phone) 763--;1 ~-c1~
(Phone)
(Phone)
TYPE OF WORK
Ui~(J ~~
D New Construction ]1(DeCk' Po h DRe-R~g ~Re-siding DLower Level Finish
DAddition DAlteration DUtility Connection )K Misc ItIIJI/ J:)dW-S
D Fireplace
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
B
S U
PROJECT COST /V ALUE $
(excluding land)
II
F
1
III IV V A
HIM R
2 3 4 5
I hereby certify that ( have furnished mfmmation on this applicatIOn which is to the best of my knowledge true and correct. I also certIfy that I am the owner m authOrIzed agent for the
suction will conform to all existIng state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
Ut;;; I hereby agree that the cay official or a deSignee may enter upon the property to perform nee~zsV
~atu~ Contractor's License No. ' Dare
x
."
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Z. 5lJ 0.- C/lJ
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
This Application Becomes Your Building Permit When Approved
Paid
Date
'7f.1 . 0 ()
13_~. O~
Buildlllg Ofticial
Date
# $
# $
$
$
# $
# $
I $
I $
"I $ 1~. 00
ReiN 0 +75'97
By '..L. ,
0
ThiS IS to certify that the request 10 the above applical10n and accompanymg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constltutes a temporary Certificate of Zoning 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