HomeMy WebLinkAboutBuilding Permit 09-0992
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~
ADDRESS ~()q f ~ ~ (6Q
v
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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COMMENTS:
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
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
i-FINAL
o SITE INSPECTION
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X.WORKSATISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORR~ORK' CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
,CAL: -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQU/REMENTSARE FOR YOUR PERSONAL HEALTH.{ SAFETY!
INSNon
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
J YelJow
File
City
Applicant
(Please !Vl'e or print and sign at bottom)
, ADDRESS
30 ttl
5f'rl;'~ Lqk<- ~tJ/
Date Rec' d
17-~ r () ~
l PERMIT NO.
OCl099z-
ZONING (office use)
~
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID
OWNER
(Name) -r7, '-'..$
(Address)
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4sbc../
(Phone)
'S-.)..- WO-~Y3~_
BUILDER
(Company Name)
(Contact Name)
(Address) rt 3 ~
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i) 4'1 GIS c++ l.-..
/gs-A ~ N....
(Phone)
(Phone)
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~ I.,). - '7 ~7 - 7~ 7.:2
TYPE OF WORK 0 New Construction ODeck OPorch [JKe-Koofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditJOn OAlteration OUtility Connection
CODE: OJ.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
o Misc,
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have hlrmshed 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
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official can re e is permit for JU t cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns,
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Date '
x
Signature
Z-oS-~ J' /?b
Contractor's License No,
Permit Valuation
Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I
1$
I
I $
I
I $
I
i $
I $
I
I $
I
I $
I
1$
I
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
TOTAL DUE
#
#
#
#
I $ I
~
I $ I
I
I $ !
I
I $ j
I
I $ j
I
I $ j
I
I $
I j
I $
I
I $ 7~. dO
Z-Se;
Paid
Date
This Application Becomes Your Building Permit When Approved
Building Ofticial
Date
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, TIllS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence, Before occupancy, a CertIficate of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372