HomeMy WebLinkAboutBuilding Permit 09-0083
DATE TIME
CITY OF PRIOR LAKE d /, /" /
INSPECTION NOTICE SCHEDULED Tt~/ Ifr
ADDRESS ;;f{().-;).. ~Drl'lI\C..... L l( (2)
, IJ
OWNER CONTR.
PHONE NO.
PERMIT NO.
(j- 0083
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
() 0 MECH FINAL
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
r;;r'FINAL
/0 SITE INSPECTION
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j WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECrzjK' ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
~ALL OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3. / 7.1
White
Pink
Yellow
File
City
Applicant
(Please type or print and si~n at bottom)
ADDRESS
SP/4Nes,
L/tlc.e
eo
292-Z
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER 1 Ar-
(Name) <:: LLL: t'u._jJJ..p. L
PERMIT NOr? 9. o6U
.
ZONING (office use)
PID
(Phone) llll,,,, ~3.5Ci
o I'L q~7- '"'2-1" - '12.01
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
/
o New Construction ODeck OPorch M~e-ROofing
OAddition OAlteration o Utility ConAn
o Misc.
ORe-Siding OLower Level Finish
o Fireplace
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group:
Division:
A
R
5
B
S
III
H
2
IV
I
3
V
M
4
II
F
1
I
E
U
PROJECT COST /V ALUE $
(excluding land)
A
B
I hereby certily that I have hlrmshed Information on this applicatIOn which IS to the best of my knowledge true and correct I also cerlily that I am the owner or authonzed agent for the
above- honed property and that all construction w1l1 conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
otlicial revoke thiS permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed lnSpcctlOOS
x
~ '---1nL~ J
, Signature
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
~tCt
3" 1'7. 0 q
/
Buildll1g Otlicial
Date
3-' l)-cPt
Date
# $
# $
$
$
# $
# $
$
$
$ 70. pt 0
()
R.Pteipt No. 572. 7cp
By ~
C
ThIS IS to cerlily that the request In the above application and accompanymg documents IS 10 accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constItutes a temporalY Certificate of ZOning compliance and allows construction to commence Before occupancy, a Certificate ofOcclIpancy must be
isslled
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any