HomeMy WebLinkAboutBuilding Permit 03-1027
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
,t;{()( (0"'1c.l.s..,-i",,,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~
~AL vulL-
O SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
/5-2-(;
'1-IOL.{
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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yVYORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: f1tV-:7 25.). r....-tl ~ner/conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETYI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please.!VDe or Print and sign at bottom)
ADDRESS
~/,,/ ;to(UV()5 ~6'!6- ~~6" 6. t:
LEGAL DESCRIPTION (office use only)
y / ~ 4'~
LOT BLOCK ADDITION
OWNER
(Name)
(Address)
BUILDER
(Namp\ ,/1 l'
')<1rl"'<:n:Y\./, ~.
- .
Date Rec' d
S'~ 5-63
I PERMIT NO.O 3 - J/);r11
White File
Pink City
Yellow Applicant
ZONING (office use)
K-/
PID~5 - gqq- 00<6-6
(Phone)
(Contact Name) .../e'5s,.,...~~.s
(Address) ,?Ctf'60 ~-d~""'<1~ CT' ~ A!'C
~"'~ A?/V ~:s~,r'!>('
(Phone) 9~;;l - ~.f"$- )',f()f("
(Phone)
c4l"V>-U -.' $~e-.-r/t3iI{.sb'V
?5.;l-..;I~6 -/ad~
TYPE OF WORK
D New Construction
DLowef Level Finish
Cllbeck
OPorch
ORe-Roofing
o Fireplace DAddition DAlteration
->
PROJECTCOST/VALUE (excluding land) $ -l7~~.
o Misc.
ORe,Siding
DUtility Connection
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 agent 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 plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the t'~~j-'~"J to perform needed inspections.
~."e...kL ~
x
,
Signature
I Permit Valuation
I Permit Fee
1 Plan Check Fee
I State Surcharge
I Penalty
) Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
3oet'. -l
$
$
$
$
$
$
$
$
i 13\ j '!)
RT.,l,J"
.P1!l
If.O
This1fJalImes Yom Buildmg P7 ~e:;proved
, Buildir/g Official Date
$
$
1$
1$
1$
1 $
1$
1$
~ecl 8,c..--0:3 1,,$
, .A 1/
/'5'1' f &- Receip;l~o, q-7 b Fl./
. .r. /J V) By r
()
A/a:;os6S"7
Contractor's License No.
Park Support Fee
#
rh~3
, 'bate
1'1?,tt,
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
SAC
#
Water Meter
Size 5/8"; 1 ";
I Pressure Reducer
1 City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
1 TOTAL DUE
#
#
I Paid
I Date
~
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS SID I p(JAld..s~~ /..N
TYPE OF WORK De.c./C. .
USE OF BUILDING SF
, PERMIT NO. 0 a; If);;''' DATE ISSUED -8--' ~3
'BUILDERb~ I-HA-t' PHON~~.;t.il'-13~l/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
, FOOTING I fW I f --('0-(/1;;,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I
, FINAL
YI/v/
~-j.~-c.J7
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
"