HomeMy WebLinkAboutBuilding/Change In Use Permit 07-0178
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
1-1 -4-('1
ADDRESS
'1773 6),{fo ~ S' f'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7-(7 tV
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
; MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~K: ~ FOR REINSPECTION BEFORE COVERING
Inspector: J/f'( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERllJ41CATE OF ZONING COMPLIANCE. .
AND \.J I ~ITY CONNE", I JON PERMIT
Date Rec'd
4,307
~ =- ~~ I PERMIT NO. a
) Yellow AppIicoIII 07. 0 II v
CPIcue tne or print .... sial at bottom)
ADDRESS ( )
'f173 D/M.;-r,q 3-rtz<<,.:z- eM [}II M /!!lV .5 f .
LOT
BLOCK
LEGAL DESCL. :a ...ON (oftic:e use only)
ADDmON
OWNER
(Name)
(Address)
(! I All) iA J. /(v tI-L
,
(phone)
BUlLDEll
(Company Name)
(Contact Name)
(Address)
//vP/L
(
..5/1 !.--(J/J )
"
ZONING (oIIice Ulel
PID Z b.
952- 99L/- 079tJ
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofin& ORe-Sidina OLower Level Finish 0 Fireplace
OAddition OA.......;on OUtility Connection 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Coastmction: I
Ocatpanc:y Group: A B E
DiYision:
(phone)
(phone)
n mIVVAB
F HI MRSU
1 Z 3 4 5
PROJECT COST /V ALUE S
(exc:lwlinsland)
I badly catilY thaI I have Iimtished information 011 this application wblcb is to the best of my btowledJlr llUe and ........ I also mtitY thaI I am the owner I. autborizrd aamt for the
abov~--:n~',.~. -'.' ..J tha~ ~t1ion will conform to all cxistiJl& state and .Jocallaws .and will , . .. .J in a... ':'.na: with 511...... 11iIans. I am. awan: thaI the buildinl
~ canW tbU fPJ;;H' I badly 11Ift that the City official or a cksign<< may enter upon tile ", ...} to perfonn ~~.. "5 :s() 7
. b siPatwe I Contractor's License No. .. Da~
Permit Valuation
Permit Pee
Plan Check Pee
State Surcharge
Penalty
Plumbing Permit Pee
Mechanical Permit Pee
Sewer &: Water Permit Pee
Gas Pireplace Permit Pee
$
S
S
S
S
S
$
$
I Park Support Fee
I SAC
I WaterMeter SizeS/S"; I";
r.. ......Jre Reducer
Sewer/Water Connection Fee
Water Tower Pee
Builder's Deposit
Other
TOTAL DUE
I Paid
I Date
4-0_ 00
4 3.0"7
f
TIds Application J:, ... . ,.. .1 Your Buildiq Permit WIIea A, I ".. .1
Buildina Official
Dlte
## '$
# S
$
$
# $
## $
S
$
$ 40.00
lk__:J~ No. S3 -;; ~ c~
Bv ./f... . I
0
TbJI is 10 mtilY thaI die request in tile above application and a..., '.1' .,:inll documents is in lICCtlI'dance with the City Zooinl Ordinana and may, ....J as reqUClltCd. This documenl
whm 5iped by tile City Planner constitutes a...... ..,.., Certificate of Zonina compliana and allows .. ...". JCtion to c:onunence. Before occupancy, a Ccrtilicate of Occupancy must be
issued.
l'IIDninI D........ .
Dee S1lOCIal CoacIitioJlI. if laY
24 hour notict for IlIlllspectlonl (9S2) 447-98~. fax (!)g) 447-4U!l
16200 EasIe Creek Avenue Prior Lake, MN 55372