HomeMy WebLinkAboutBuilding Permit 03-1129
CITY Of PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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DATE TIME
<1~2-0
ADDRESS
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OWNER
CONTR.
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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o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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FjWORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspeelor: _ I~ ~- j,,' d7 OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please type or orint and si2ll at bottom) ,,~ I RI'5/
ADDRESS Cf -ry 7 -
116l1g EL~A A-vF <S W
While File
Pink City
Yellow Applicant
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER . .J d. /) n v .
(Name) 'Ucr ~~Ul~ &het{h:t.lp' .J4.
(AddreSS)\tpq M t/M AV6 .SW
Date Rec'd
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I PERMIT NO. OJ . /Iz.q
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ZONING (office use)
PID eS':" Irk. ()/(".D
(Phone) 95:J./c.f<.l7 -</4'11-
BUILDEI\^/,"AA.,.) ".'t
(Name)~ ~
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(Contact Name)
(Address) 9tJ
(Phone) JJt V' t./ 25 -'22 Z 1
(Phone)
vt 5~<../45
TYPE OF WORK
o Misc.
D New ConsbUction
DDeck
DPorch
ORe-Roofing
~Re.Siding
DLower Level Finish
o Fireplace DAddition DAlteration DUtility Connection
PROJECT COST IV ALUE (excluding land) $ df). ~,C'X!/
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
) 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
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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 the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building 0 cia! can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter?"lepr'f~pefo~eede insp o~s. _ 1 ".t1-' . I /
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Signature Contractor's License No. Date
I Permit Valuation
J 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
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This Application Becomes Your Building Permit When Approved
Building Official
I Paid
I Date
Date
# $
# $
$
$
# $
# $
$
$
I $ ""7~ f/U
I ReCei.L2.. o. K {,~7
By (.T.~
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This is to certity 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 impections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372