HomeMy WebLinkAboutBuilding Permit 03-1349
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED ,.-..,. 10 ZL/-f/J
DATE TIME
ADDRESS
.GiS e~k~
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
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COMMENTS:
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~
C:t -z...- /
.L l..-r.
5-/1'/t1
o EXIGRADIFILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLlNE AIR TST
D
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6'WORK SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
1,i 'If)
Inspector: , 1/ j Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
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
10. 10.3
(Please type or print and SiAA at bottom)
ADDRESS 5395 &etJtJ/c..J'
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO.~-/3tfCl
~I /C.-
S'6
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zs-. 1'/2,/ . (j/~ 0
OWNER il
(Name) ~YU~)~V1
I
L. Wa 'I'~9.../
(Phone) .!lS;:)...... 44 'j -. LJ4?1
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
OLower Level Finish
o Fireplace
o Addition
.
~e-ROOfing
o Alteration
ORe-Siding
TYPE OF WORK
o New Construction
ODeck
DPorch
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) S
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 th7t th uilding offici can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upo~opell "perform ded inspecti s.
X ;n/'~0 ( . Wt ./ /0- ? - 0 "3
- d Signature Contractor's License No. Date
V
I Permit Valuation 2.SDOqO 0 Park Support Fee # $
I Permit Fee $ SAC # $
I Plan Check Fee $ I Water Meter Size 5/8"; I"; $
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 $ ~r -"', $
I Gas Fireplace Permit Fee $ ::.:o~~ $ 7~.OO
/':' .J ,1
This Application Becomes Your Building Permit When Approved Paid /U' VV'_ ReceiPtJl 4- 5t,' /
Date /d. 7.0 I By
Building Official Date iT
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