HomeMy WebLinkAboutBuilding Permit 03-0955
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ---1t '70tf
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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o W~SATISFACTORY. PROCEED
~RRECT ACTION AND PROCEED
o CORRECT ~A:.rLL FOR REI~TION BEFORE COVERING
Inspeelor: f f,. g- (f: OWner/Contr:
CALL 447-985Q FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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HiSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. While File I PERMIT NO I
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ADDRESS ZONING (offkeuse)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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OWNER
(Name)
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(Phone)
(Address)
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BUILDER
(Name) P lCJ::..r
(Contact Name)
(Address)
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(Phone)
'9 ~2: - 7qlf,,- Z070
OLower Level Finish
o Fireplace
DAddition
ORe-Roofing
DAlteration
~e-siding
DUtility Connection
TYPE OF WORK
o New Construction
DDeck
OPorch
o Misc.
PROJECTCOST/VALUE (exdudingland) $
9--17D .=..
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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
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Signature Contractor's License No. Date
I Permit Valuation '2S00,OlJ I Park Support Fee # $
I Permit Fee $ I 14. 75: I SAC # $
I Plan Check Fee $ - I Water Meter Size 5/8"; I"; $
I State Surcharge $ / ,2-S I Pressure Reducer $
I Penalty $ I City SAC and WAC # $
I Plumbing Permit Fee $ 1 Water Tower Fee # $
\ Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ 7/:;.00
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This Application Becomes Your Building Permit When Approved I Paid rir7",.o-o ReceiJ2tNo. i!/'SO ~
~ . I Date 'Zp,(07 Bv 0<,. 'L... 71'.12.' P
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Building Official I 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. 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 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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