HomeMy WebLinkAboutBuilding Permit 04-0862
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
s.z,tt. oS-
ADDRESS
4-425" tJ/J 077t ..1 (
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 SEWERHOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
4,&8~
o EXlGRAD/fIWNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
;< $'ID/N7
(!." l- OS FS
Dll f5" I ()
771'6 PI u6
j /V,t1 eTlVI TV
/.
, 0 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~A' " FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Centr:
~ALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVA~J~C
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY/
INSiWm
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. f;. 04--
File
City
Applicant
I PERMIT NO. 0'1 ~ OK0'Z-,
White
Pink
Yellow
(Please type or print and si~ at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
ZONING (office use)
LOT
ADDITION
PID LCOf 1 ~G U 1..cl
BLOCK
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
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/A (F'
/hkp
(Phone)
(Phone)
q<;-a. ().Cj;J -j4RR'
I hereby certifY that I have tlirnished mt()rmatlon 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 aU construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted 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 property to perform needed mspectlOns,
~
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TYPE OF WORK. 0 New Construction ODeck OPorch o Re.Roofing
OAddition OAlteration o Utility Connection 0 Mise.
CODE: fIu.R.c. DI.B.C.
Type of CFstroction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
~Siding OLower Level Finish
PROJECT COST /V ALUE $
(excluding land)
x
~~
'SIgnature
Contractor's License No,
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
o Fireplace
.c;< - /'7~01
Date
$
$
$
$
$
$
$
$
$ 1(p.OO
I Paid 7{;; ,co Receipt No, r77" 9'
~~'~
ThiS IS tu certifY that the request in the above applicallon and accompanymg ducuments IS in accordance with the City Zuning OrdInance and may proceed as requested ThlS~ducument
when signed by the City Planner cunstltutes a temporary Certificate of Zonmg cumpllance and alluws cunstruction to commence, Before uccupancy. a Certificate uf Occupancy must be
issued
This Application Becomes Your Building Permit When Approved
~~ ~~;t-; /?~~;bCL
Buildlllg Otlicial , Date
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