HomeMy WebLinkAboutBuilding 09-0152
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 4lr1J.Jl (),1.u~ . ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: Retoo~
_ I j f\ ['I
( ~~~fr101d-f
DATE
~
TIME
0'1 - 0 I~'A..
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'" I
{\So Ita, l (}..('c;Nj
, U
XWORK SATISFACTORY, PROCEED
. 0 CORRECT ACTION AND PROCEED
o CORRE71'frRK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: '11Il Owner!Contr:
CAL! ~7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~n at bottom)
ADDRESS '1 &~ It
DA~ WWj)
C;J2CL t
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER~~~
(Name) o tIt.. I
y ~lt 0
i (UfiQ
OAii~OOv
Bf-srH'
Cuti (
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
] White
Pink
Yellow
File
City
Applicant
PERMIT NO. cq, 62-
!J-G
ZONING (office use)
'(?-.7-
PID
(Phone)
f52 - y L(~ - ff~5
:J ,f- -
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ~e-ROofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteratton OUtility ConnectIon
/1
I hereby cert y h,al ]~hav furOlshe 1Ofor at,lon on this application which IS to the best of my knoW,lcdge true and correct. I also certify that, ] am th,e ,owner or auth,ollzed agent for the
above-mentl 'd prope and t all co trucuon will conform to all eXlstmg state and local laws and wIll proceed m accordance with submitted plans I am aware that thc blllldmg
otlicia] can '0 thIS rmlt ~ r , ,I e rurthcrmor~gree that the CIty official or a deSignee may enter upon the propel1y to pertorm needed mspectlOns
X fit ,-/---/fv.-t)7
v
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
IV V
I M
3 4
A
R
5
II
F
1
III
H
2
I
E
Signature ~
Permit Valuation 2 S~ - I
Permit Fee $ ('4..- -: ~ I
Plan Check Fee $ I
State Surcharge $ (~ 2.-.'::;- I
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ I
Gas Fireplace P~it Fee 17 J $ I
IPI~~e#m~ I · .
mA'i;:)djif7":nm4WhJ,^;:z .
, Bulidllll! UlliClal --,_ \ Dille L 4
--
o MISe.
B
S
$ '-10m .0-0
U
PROJECT COST IV ALUE
(excluding land)
Contractor's License No,
Date
Park Support Fee
SAC
$
$
$
$
$
$
$
$
$
1 &~-
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
.....-l~. I
4-{f~!'1
I Receipt No... S 7 TL 3>
I By {L/Y'd-
ThiS IS to certify that the request in the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested Thls document
when signed by the City Planner consututes a temporary Certificate of Zon1Og complIance and allows construcuon 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
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any