HomeMy WebLinkAboutBuilding Permit #03-1208
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
r:. 7ro
(lUShc-- 12 J
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
(c - TO~
COMMENTS:
~
/ I
/ / 11')5~
( I//LV .
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DATE nilE
+,o-t(:: ~
5- I./-()lr
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-. ..---.........
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/-'/le /
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---------
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ FOR REINSPECTION BEFORE COVERING
Inspector: tfJ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
t/., /0,01
I. White File I PERMIT NO
2. Pink City . 0-:> -/706
3. Yellow Applicant '...) V 0
(Please tyoe or Print and sign at bottom)
ADDRESS
~750
1!A/J17 C!-- jU::)
ZONING (office use)
et.r.f}
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25./4-0.0 /0.0
OWNER
(Name)
I?~e ~<SJ~ J( i1~'
(Phone)
9 tf:;.. -'1/1() - ,;1/9.:z.
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
DLower Level Finish
o Fireplace
DAddition
,
~e.RoOfing
o Alteration
ORe-Siding
TYPE OF WORK
o New Consttuction
DDeck
DPorch
DUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
I hereby certify that I have furnished information on this application which is to the best of my knowledge ttue and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all consttuction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I m aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~ter upon erty to perfo g;;:;;~ q .. / ~ ..() ~
Signature Conttactor's License No. . Date
I Permit Valuation 'Z.S06 dO Park Support Fee # $
I Permit Fee $ , 7t./-1r SAC # $
I Plan Check Fee $ - I Water Meter Size 5/8"; 1"; $
I State Surcharge $ I. V- I Pressure Reducer $
I Penalty $ I City SAC and WAC # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other $
Gas Fireplace Permit Fee $ I TOTAL DUE $ 7~.oO
,
This Application Becomes Your Building Permit When Approved Paid 7fL.tJ-r) ~~2 '? ()
Date . 9../0. 0 J
Building Official 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 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372