HomeMy WebLinkAboutBuilding Permit 03-01276
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
.(!J A-d ~
SCHEDULED
LII'i'l" (J!c..~_.r
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
S;,.J I ''1j
U ~{ baus.,
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.......
-
DATE TillE
1lJ-/ -:k'J
3-/1..7(,
o EXIGRAOIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
I/ViM lu... to
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r ~, Ip. /
f\/L-/j
/
~
o W~K SATISFACTORY, PROCEED
~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
f1;y?
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND J]TILlTY CONNECTION PERMIT
Date Rec'd
9./~0.7
I. White
2. Pink
3, Yellow
File
City
Applicant
I PERMIT NO'03-/Z7&
I ZONING (offic,u,,)
(?lease t\jle or print and SilW at bottom)
ADDRESS
~/'if
r'C--DrF/f7Jr ..fI
LEGAL DESCRIPTION (offic, use only)
LOT
BLOCK
ADDITION
PIDZ5.00{P, tJ/2... 0
OWNER
(Name)
(Phone)
(Address)
~~;~)ER /)r EernuJeit'nC/ /ne. (Phone)QS,J-t(t/7-75'?7
(Contact Name) LJ SA t...c::c Ai ({~ (Phone)
(Address) t./K;;3 })31td S!ree+-liJes+ .Y:t.iJO.CK" rniJ 5537 g
.
DLower Level Finish
o Fireplace
OAddition
DRe.Roofing
DAlteration
~"Siding
DUtility Connection
TYPE OF WORK
o New Construction
OD,ck
DPorch
o Misc.
PROJECfCOST/VALUE (excluding land) $
I hereby certify that I have furnished 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 ove-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pI I m aw ~tha th building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the p rfo eded inspections. .
X . .~ . ~ Q/;Q/03
C // _ ~ature l/ Contractor's License No. Date
Permit Valuation
I 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 $
Building Official
Date
Park Support Fee # $
SAC # $
I Water Meter Size 5/8"; 1"; $
I Pressure Reducer $
I City SAC and WAC # $
I Water Tower Fee # $
I Builder's Deposit $
I Other $
I TOTAL DUE /1. $ 7?,OO
/I
Paid ~(p. v-/ IvNO .". .n~~ v I
Date &). /9'.6 "7
This Application Becomes Your Building Permit When Approved
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. 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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lak" MN 55372
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