HomeMy WebLinkAboutBuilding Permit 09-0375
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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CO-NTR. r
OWNER
PHONE NO.
PERMIT NO.
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
o MECH FINAL
COMMENTS:
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DATE
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TIME
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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}d WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRE70RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
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,CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
(Please type or print and si~n at bottom)
ADDRES~.
CITY OF PRIOR LAKE BUILDING PERMIT, J)~tp Rp(d
TEMPORARY CERTIFICATE OF ZONING COMPLIANrnm @ ~ Q \fl ~-: II
AND UTILITY CONNECTION PERMIT 'U~ L.::J i !I
, J U N 1 5 2009 ~
PERl'lf.' NO. rU, 'S7~
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I White
Pink
J Yellow
File
City
Applicant
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4, H..I..-.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
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(Phone)
(AJidress)
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(' BUILDER
(Company Na ie)
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch Me-Roofing
DAddition OAlteration OUtility Connfctio-~
~ D o Misc.
CODE: .R.C. I.B.C.
Type of onstmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
[ hereby certifY that I have hlrmshed mformal1on on this applicatIOn which is to the best of my knowledge true and correct. I also certify that I am the owner or authoIlzed agent for the
above-mentlOned property and that all constructIon wIll conform to all existmg state and [ocallaws and will proceed in accordance with submllted plans I am aware that the buildmg
~tiCJal ca rev':;ls pel'W~uIt~elmOle, I heleby agree that the CIty~l; &e~?n7 ~ ell upon the plOperty to pel form needed mspecl10ns
Slgnatu~ Contrlctor's LIcense No Date
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I
Permit Valuation
Park Support Fee
#
Plumbing Permit Fee
Mechanical Permit Fee
Water Tower Fee
#
$
$
$
$
$
$
$
$
$
(0--
Permit Fee
$
$
$
$
$
$
SAC
#
Plan Check Fee
Water Meter
Size 5/8"; 1";
State Surcharge
Pressure Reducer
Penalty
Sewer/Water Connection Fee
#
Builder's Deposit
Sewer & Water Permit Fee i $
I Gas Fireplace Permit Fee I $ "-
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Tm' APPIP:J~'Buildmgp'nnJI w~~ Z1,~~~ ~~~ t~Tr ~ ~
""""'t:"'" __________ ~"" , ,~
ThIS IS to certify that the request in the above applicatIon and accompanymg documents IS m 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
isslIed
Other
TOTAL DUE
~~ceiPt n~';S.S
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