HomeMy WebLinkAboutBuilding Permit #03-1530
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
tH"Z--/D3 Ll~\{s
ADDRESS
3)12- CJ fC(~) ~ J,\
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'3 -tS3o
COMMENTS:
o PLUMBING RI 0 EXIGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~ a~ID"I.< (('''~ '-iY.7''i~
~RK 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/
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
Date Rec' d
L White File I PERMIT NO 3 ~
2. Pink City . 0 -/ ,~3
3. Yellow Applicant , 'J _
3~/d-
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
(Phone) ~~l-~)o ~ ~
OWNER f\.
(Name) \:M'-^^
~\,.JV\W
(Address)
PID 075 ~ 1010- ()O J-
BUILDER
(Name)
(Contact Name)
(Address)
So.
TYPE OF WORK
o New Construction
DLower Level Finish
DMisc.
(Phone) b\1-~. bq ~ ~ rs'S
(Phone)
f,- 'Lv~ ~tA. MN. ~ ~ 1- :s
o Deck
OPorch
Re-Roofing
ORe-Siding
o Fireplace
DAddition
DAlteration
DUtility Connection
PROJECTCOST/VALUE (exdudingland) $
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
enter upon the property to perform nee inspections.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Official
Date
Wb'l~~
Contractor's License No.
IA 1 Lsr,1 103
~
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7~ ,..-"
J
I ~;ceipt~S~q<(
I Paid
Date
J~;:3
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