HomeMy WebLinkAboutBuilding Permit 09-0158
DATE TIME
CITY OF PRIOR LAKE )W
INSPECTION NOTICE SCHEDULED
ADDRESS f (a 1 ;L'2..., S~~
,
OWNER CONTR.
PHONE NO. PERMIT NO. q - I JC;
o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
iLFINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
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A WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o COR~EC O~, CALL FOR REINSPECTION BEFORE COVERING
Inspect r: ft _ Owner/Contr:
"
CA -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE BUILDING PER.MIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Duttl Ktle'd
White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO.
09--ls"g- I
(Please type or print and sign at bottom)
ADDRESS
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ZONING (office use)
0~y e. Ie
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
a,r Cd
f11 c r Ie JJ ..-r-
(Phone)
/fZ- t/lI7-1~{ zy
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
..s/llv?t!
~ A,/t/f E
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch ~.Roofing [B(e-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.C. o Misc.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certii)' that I have furnIshed mf,ltmation on this applicalIon which IS to the best of my knowledge true and correct. I also certli)' that I am the owner or authorIzed agent for the
above.menlIoned property and that all CDnstnrction will conform to all eXlStIng state and local laws and will proceed In accordance with submItted plans. I am aware that the buildIng
otficlal can revoke t~S7Tllt for Just cause FIlIthelmOle, I heleby agree that the CIty offiCIal or a deSIgnee may enter upon the property to perform needed InspectIOns
X _~~__ ~ 1-LC--L'!
d Stgnature Contractor's License No Date
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other Re -jZ t:'O-r $
TOTAL DUE $
7tf
76,
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Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
.4,,~- ~.~
/" l3uildlllg Ot1icial
C
.~~% q
Date r
Paid
Date
76' 0 0 Receipt No.
Lj/;?O/ to 9 ~ By
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.5772 Cf
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This Application Becomes Your Building Permit When Approved
ThIS IS to cerlIi)' that the request rn the above applicalIon and accompanyrng documents IS rn accordance with the CIty Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner CDnstltutes a temporary Certificate of Zonrng compliance and allows CDnstnrclIon to commence Before occupancy, a CertifIcate 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