HomeMy WebLinkAboutBuilding Permit 03-1215
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE 1...
SCHEDULED
ADDRESS
4628
PLEASANT
03-1215
Re-Side
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
U ....LUnl_h._
UGRAD/FILLlNG
u ~OMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~b.(\5E F!b.e
N\ik~ Pete.rson, Building Inspt::;(,.1 vr"
D!:~ ? ?nni
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .( SAFETY/
INSNOTI
(Please type or print and sign. at bv..vm)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO
2. Pink City . /')3 _ I ':::1/5-
3. Yellow Applicant { / (;/.
'-10 ~ >< - If) J 1CtAJwnl- ~//
LEGAL DESCRIPTION (office use only) a
~~q .
LOT BLOCK ~ ADDITION ~ CL~
OWNER - r. oil ..!
(Name) S 7_' e tV
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
<.-<; fLLCC(J
U OS$ <c rJ
o New Construction
OLower Level Finish
ZONING (office use)
PIDdS -()OJ..t) jl{-6
(Phone) q -5 d - t.j t.{ 0 ~ q I ~ ~
(Phone)
(Phone)
DDeck
DPorch
ORe-Roofing
o Fireplace
o Addition
DAlteration
~e-Siding
OUtility Connection
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
;tel5n~ormnU;s:~ 9 -{ / - CJ 3
Signature Contractor's License No. Date
I 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
PROJECT COST IV ALUE (excluding land) $
asDO,-
$ 74, 7'5'"
$ / ' ;). t:.5"
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ 7fR,---
Receipt No. ij 5 55 :.t
By U-- -
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
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
#
#
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
~
-
I Paid ' /1..:.. -
I Date Cj- /1- "3
.