HomeMy WebLinkAboutBuilding Permit 04-0854
CITY .OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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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 RNAL
o MECH FINAL
COMMENTS:
DATE TIME
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o EXIGRAD/FILLING
o COMPLAINT'
o FIREPLACE RI
o FIREPLACE FINAL
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,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 INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH &: SAFETYI
INSiton
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
White
Pink
Yellow
File
City
Applicant
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LEGAL DESCRIPTION (office use only)
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ADDITION
OWNER
(Name)
f t {3 6 t<1~
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vV
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
U;:r;;"'
PERMIT NO. ()t./-
3)~
zl!f5GEffice use)
PIQ-2~- ~ (Jq'-(- OJ-:: V
(Phone) L/ if 7-6 {' 2. 7
(Phone)
(Phone)
-
TYPE OF WORK 0 New Construction ODeck OPorch ..tIRe-Roofing ORe-Siding
OAddition OAlteration OUtility Connect~n 0 Misc,
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
OLower Level Finish
o Fireplace
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have fi.lrmshed mformation 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 eXlsllng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:flClal can rf?ke IS pel mlt for~::: F':h'':; ree that the CIty offiCial or a deSignee may enter upon the plOpeny to perform need;msp;:/~ y
II~ Signature Contractor's License No V Date
Permit Valuation ;;;2 Yro- I
Permit Fee $ 74, 7sl
Plan Check Fee $ /r~~
State Surcharge $
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ \
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
1311ildll1!! Ofticial
Date
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
"/~.~
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# $
# $
$
$
# $
# $
$
$
$
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I
Receipt No.
By 0,
C.J
\
ThIS IS to certify that the request m the above applicatIOn and aceompanymg 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
ISslled
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