HomeMy WebLinkAboutBuilding Permit 04-0860
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
[J PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING RNAL
[J MECH FINAL
COMMENTS:
DATE TillE
4. 8"0
[J EXIGRADIfILLING
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
.[J GASLlNE AIR TST
!l ,~I DIN 1
~l-OS~
DIJH . 10
7716 PI 06
/ IV ~ C!.4/VI TV
/.
. [J WORK SATISFACTORY, PROCEED
[J CORRECT ACTION AND PROCEED
[J CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVA~J~C
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
INSiion
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Q '- U/Yl4
/~ j
LEGAL DESCRIPTION (office use only) /J. . '
LOT3 BLOCK ~-I ADDITION~~1J-I::t~ "..}~1i/)UU/,L PID,.,) ~ -13'-1 .. m -3 - q
OWNER ~ r-
(Name) ) fi J1A eo"? r-/;/) Iv €.J
(Please type or print and siWl at bottom)
ADDRESS
:19 1?~
(Address)
White
Pink
Yellow
File
City
Applicant
Utlu ;::1d
(Phone)
BUILDER f' "
(Company Name) ;;;rJO-P.f-, C /!/e!sC)/l)
(Contact Name) (!/..{ )p.,:,,{ /J/etf7C/j,.1/
'7 GrJ 2.
(Phone)
(Phone)
l-. jf+ 1/ k / ~ )f. ve., 7-
-'/
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ~Re-Siding
DAddltlon DAlteration DUtility Connection D Misc.1'\:
(Address)
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
Date Rec' d
I PERMIT NO. OL/- ?6c.J
ZONING (office use)
FIS/)
I
{5/- '-/S--?'- 7 L'2 5""
OLower Level Finish 0 Fireplace
II
F
I
B
S U
PROJECT COST IV ALUE $
(excluding land)
III IV V A
HIM R
2 3 4 5
I hereby certifY that I have fl1rnIshed Information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or iluthonzed agent for the
above-mentlOned property ilnd that all construction will conform to all eXisting state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
"fficial can revoke t~ermit for Just cause Furthermore, I hereEY agree that the CIty official or a deSignee may ente.r, upon the property to perform needed mspectmns
X e-/j c!?- '--l-l -,) /, 2 () LIfo 75/ 1-1 ~ q--1l-/- () Y
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
;:).5ZJ(j -- I
/'f/~..21
J'~,51
I
I
I
Water Tower Fee
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
, /0.,
g/ ;y! -(7!j
Buildmg Official
Dale
# $
# $
$
$
# $
# $
$
$
$ ?h, ..----.
Receipt No. Qr;/1'5 ()
By ,J--,
ThIS IS to certifY that the request In the above applicatIOn and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThIS d"eument
when signed by the City Plilnner constll111es a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certlticate 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