HomeMy WebLinkAboutBuilding Permit 03-1373
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS
/k!j7 y b::w /~4~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
2-137'.1
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/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
~RECT ACTION AND PROCEED
o CORRECT .~~ 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!
INSNon
(Please type or print and si~ at bottom)
ADDRESS
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rive
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
1-1 f} ....lk J
J4- \/
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
BUILDER
(Name) (lA?Pl'C.!-/#JO {n-tJ-::~77 rt .R ElM.Ol>&/.u~
(Contact Name) C.U11{ k CMPJ'CLOJV
(Address)
OWNER
(Name)
(Address)
41-0'-"
TYPE OF WORK
o Misc.
(Phone)
Date Rec' d
jD 10. OJ
PERMIT NO. OJ-In]
ZONING (office use)
PID ZS j 83. () / 9. /
(Phone) <15"2. -- 41../. 7 - B zj ~
(Phone)
CArE" .5
-:5E
7r~..'otL LA.~
ORe-Siding
OUtility Connection
I/lltJ{) CJO
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 r the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted s. 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
exnt~o e 0 e orm needed inspections.
( _ Ib-Io -0.3
--
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
:s",
o New Construction
DPorch
OAddition
~e-ROOfing
OAlteration
ODeck
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
Signature
Contractor's License No.
2--, nN . UV
$
$
$
$
$
$
$
I $
I Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
I
This Application Becomes Your Building Permit When Approved
Paid 7h.GU
Date /u.,O.. O?
Building Official
Date
Date
# $
# $
$
$
# $
# $
$
$
$ '/fo. () U
Receifo ~f477
By .
()
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