HomeMy WebLinkAboutBuilding Permit 04-1095
DATE TIME
CITY .OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
5,2.3.0%,
ADDRESS
/5cPS5 R-tOGEnoA/T~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULA nON
[] FINAL
[] SITE INSPECTION
[] PLUMBING RI
[] MECH RI.-
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
[] EXIGRADIfILLlNG
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASUNE AIR TST
[] SIOrAl6
WI tJ Od /.,..)5
COMMENTS:
~,-osP;
Dll F5' I ()
7716 PI 06
j /V ,.?) e..r/ V I TV
I
[] WORK SATISFACTORY, PROCEED
[] CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
lNSJi/OTI
4 ((R.DD
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE i (). Z I. 04-
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
\ c:) lQ 9S RidfjfXY)rflt A-ve., S S
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PERMIT NO. 04-. /0 'IS-
ZONING (office use)
f2 I S.D
PID 25. 078. 0 (J ( 0
~':e~R CX':lI-T~ \ f, pi e.s (Phone) ~2. -Z 33 135 g'
(Address) &kYy\E> ,_/' A S tJ.Jc::()V~
~~;~)ER :J()Y1Y'\ .pp~lf?~('soy) ('Dr1Sll\,lC1Ql1ne)ll~~[107~QQ
(Contact Name) -1 \ Y\Cl. \ 'L.11ft?Y\ - -, (Phone)
(Address) 'l1QD MOviY) bn-at- NCC fr1che\;\ j rYlN ~s'-l?::>2-
, OLo'fer Level ::tish 0 Fireplace OAddition o Alteration OUtility Connection
]i..MiSC. ~ I ~\ (AI ntl'ROJECTCOST/VALUE (exc1udingland) S '5, ~
I hereby certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or
authorized age for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pia . I am aware at the ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter upon t r to p. fo ne ed inspections. [lOt3l ~ lL J ~ f -LlJ _ ;<~
/ I Contractor's License No. Date
J
Permit Valuation
TYPE OF WORK
ODeck
o Porch
ORe-Roofing
o New Construction
I
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
Park Support Fee
SAC
$
$
$
$
$
$
$
$
Water Meter
Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
'/(p.O(J
/() ~z.>(J4-
This Application Becomes Your Building Permit When Approved
Paid
Date
Building Official
Date
ORe-Siding
#
$
$
$
$
$
$
$
$
$ I V . 00
#
#
#
Rece~~x.
By r~'e-
4t:3(Y7
,
This is to certify that the request in the above application and accompanying 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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245