HomeMy WebLinkAboutBuilding Permit 09-0350
DATE
I
SCHEDULED ~ e.-; \,.,r
. '!
w ;lQ Lh. M- tr
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS J t[ ~c:;r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o )NSULA TION 0 SEWER HOOKUP
fl FINAL 0 PLUMBING FINAL
o SITE INSPECTION /J 0 MECH FINAL
COMMENTS: f[(.e,~
V
r
'--
( In
--./ ^ ~ J\
~ ...>(. ( ) V'-{
f'
L
\ -
TIME
Cj - .!s-O
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
(
\()
/}.A~
I {flRi( he
V' -
^LT'U ~
, ....,- U'
'::IZC..WORK SATISFACTORY, PROCEED
o CORRETliiCA ION AND PROCEED
o CORREC , CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL~~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/J'/SNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE BUILDING PERMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Dut~ Il..~~' d
6, //27
(Please type or print and si~n at bottom)
ADDRESS
\,~~~ \}J\ \dernfc=r~ Cr\- s,ij.t:
.?~w
White
Pink
J Yellow
File
City
Applicant
PERMIT NO.
o 9. OJ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
rT\ i (, h,f' ,\e C,-o Y\ d 0-
\ 1d-6Q W~ \d -fv(\t:'~::/::J
(Phone) Co \ d q Co I
3/(00
(Address)
~-\- S. E' .
BUILDER ? v' ~ (\. ^
(Company Name) 'to pe - "'-l \ ex. \ fYI
(Contact Name) 'R', C_ h I
(Address) A<o'DC:::> 1\ i CO \:S '-PC)
c.)()\ V+\ 0 v\
(Phone)
(Phone)
c.,S l qq 4 de'),) <6
~Q?)qn ,MAl
TYPE OF WORK 0 New Construction DDeck DPorch yfRe'RoOfing~.. _~~ DLower Level Finish 0 Fireplace
DAdditIOn DAlteration DUtility ConnectIOn " 1 0
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 /V ALUE
(excluding land)
$
IClce c
I hereby certify that I have hlrmshed mtill"mation on this applicatIon which 15 10 the best of my knowledge true and correct. I also certIfy that I am the owner or authortzed agent for the
abovc-mentJOned property and that all construction Will conform to all existmg state and local laws and will procecd in accordance with submItted plans. I am aware that the buildmg
official can revoke thiS permIt for Just cause Furthermore, I hereby agree that the city official or a destgnee may enter upon the properry 10 perhlrm needed rnspectmns
x'YL/ill I 111 I ~Q/11l( r: 'de) sq ~ \ l:;~ ~ 0 [01 J 0 q
- ~fa~re ....) Contractor's LIcense No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
# $
# $
$
I $
# I $
# I $
I
$
$
$ -J~
Rei! rrt (,J~
By .
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Y OUf Building Permit When Approved
Paid
Date
'1 i?--
'Jf) r>1
I
Building Oftieial
Date
ThIS 15 to certify that the request 111 the above applrcalIon and accompanyrng documents is 10 accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the CIty Planner constItutes a temporary Certificate of Zon1l1g complrance and allows construction 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