HomeMy WebLinkAboutBuilding Permit 03-1235
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
4416
MAPLEWOOD
03-1235
Re- Roof
ADDRESS
PHONE 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
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
CLOSE FILE
,\\iJ\t::; F't::; I t::;r.~Url, Suilding InspecTor
nt=C 2, 2003
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
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
fI6.0]
PERMIT NO. OJ-/235
(Please type or print and sign at bottom)
ADDRESS
ffly, n/tptAaVOOD ~,
LEGAL DESCRu'nON (office use only)
ZONING (office use)
10/
LOT
ADDITION
PIDZS. I OS_ 0 04-' ~ ()
BLOCK
OWNER
(Name) r J:;.L/V I
(Address)
_ (Phone)
(},57 --V-V7- :jCJt 7
, .
L ,''L Y'" <. 0 /\...
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
-
~e-ROOfing
OAlteration
o New Construction
DDeck
o Porch
OLower Level Finish
o Fireplace
OAddition
o Misc.
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
OUtility Connection
1 hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 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. 1 am aware that the building official can revoke this permit for just cause. Furthermore, 1 hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
x~.,1A ~~~. ./ q-/t..-cJ3
-- ~ature Contractor's License No. Date
I Permit Valuation Park Support Fee #
I Permit Fee $ SAC #
I Plan Check Fee $ I Water Meter Size 5/8"; 1";
I State Surcharge $ 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
I Sewer & Water Permit Fee $ I Other
I Gas Fireplace Permit Fee $ I TOTAL DUE
This Application Becomes Your Building Permit When Approved
1ft." 'JJ
Paid
Date
Building Official
Date
$
$
$
$
$
$
$
$
$ 7(;, & tJ
n
Receifl)"N o.
ByA~
tJ
-
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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 Lake, MN 55372