HomeMy WebLinkAboutBuilding Permit 09-0333
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
lGa. ~'l.l
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
JrFINAL
o SITE INSPECTION
COMMENTS:
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SCHEDULED
DATE TIME
U III 1/)'1
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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,J( WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ALL FOR REINSPECTION BEFORE COVERING
Inspector: /)/ f) Owner/Contr:
V
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1Il./7- 9853
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~ - b_cj'
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. OCf. 0333
(Please type or print and sign at bottom)
ADDRESS
ZONING (office lIse)
/'- 1-')/
V,'c,k,-1. ,',.., C~J"~~""" $_
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
-.)t""~~ ~ ~~ o~.-__
/~?7.J/_H~~u~
-L-:& ___
------
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
~;.'I /~. A,J
JJ- ~~____
(Phone) eJ.. ~ ~ - B.J(, -/at) ~7
(Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAdditlOn OAlteration OUtility Connecr/cYn
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certity that I have furnished mformat on this application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authof!zed agent for the
above mentJon~~telty and that all const ICt on w1I1 conform to all eXlstmg state and local laws and WIll plOceed 10 accOldance WIth submitted plans I am aware that the blllldmg
:fiClaI can rev~j IS p~ mlt for ,use Fu nel mOle, 1 jy agree that the CIty offiCIal or a deSignee may enter upon the plOperty to petform nee;:/;"; ~
SIgnature Contractor's License No ' Date
Permit Valuation
Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
This Application Becomes Your Building Permit When Approved
Paid
Date
./&
C. Y A';J Cl
v ,
# $
# $
$
$
# $
# $
$
$
/7 $ 7& U<J
1/
}fiPt No ~q7 rj--
~ .
0
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
BuilulIlg Ortlcial
Date
ThIS IS to certity that the request 10 the above applical10n and accompany 109 documents IS 111 accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner constrtutes a temporary Certificate of Zonmg compliance and allows clmstructJon to commence. Before occupancy, a Certificate of Occupancy must be
iSSlHo-'d
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