HomeMy WebLinkAboutBuilding Permit #03-0178
CITY OF PRIOR LA)(E BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY COINNECTION PERMIT
1_ White File
2. Pink City
3_ Yellow Applicant
Date Rec'd
Z-/B-CJ3
PERMIT NOo03-017g
(Please type or print and sign at bottom)
P.DDRESS
14~D'1 .'6 L LJ ~.~ ,lL/)
'7,Lt :) n.
LA k: E-
/Vl IV Cj' < SI y/
J;'l,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
4!OWNER 7) A~' i~
JJ~(Name) './
ZONING (office use)
~ L 0'" ,\./\ ,). U (S: "
~on~) l' -s' J. -",/'-15- (.151 C
(W) (;,IZ- 240-5375
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK.
o New Construction
.A-ower Level Finish
?- ~7) r-? J
ODeck
o Porch
ORe-Roofing
o Fireplace
o Addition
o Alteration
o Misc.
PROJECT COSTlY ALUE (excluding land) $
ORe-Siding
o Utility 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
ente~. ' e prop~ jO perform needed i_nSpectio'X~. '
X 'J, ..J,(,~7(J t. 7?L~~ ell ~ /0 j
~ignature I ' Contractor's License No. ' <tk15ate
I Permit Valuation
Permit Fee
Park Support Fee
SAC
4-, () () a. 0 0
$ !J ...,. 2- 5"
P~Q~kF~ $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permi;fee $ 4- o. () 0/
- . Ymu~w~ p;;tm~ved
BuUdil(g Offi~ } / D~-=<;
~ I
$
$
$
$
$
$
$
$ I. oJ
$ /70. '2-0
/1
Re., ceipt~. +3~~'7
By ~.
()
#
#
'N ater Meter
Size 5/8"; I";
2.0 a
Pressure Reducer
40.00
City SAC and WAC
'Nater Tower Fee
#
#
Builder's Deposit
Other
eL-6M"'jeI tJ14 ~
TOTAL DUEM1L6O Z;' /I'J." 03
I Paid /70.25
I Date ? ".ltJ~ () J
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /'4307 8L,,{J6ff/~ I~/~
NATURE OF WORK L owe7C L-6V6 L-
USE OF BUILDING /e-€f ~/~
PERMIT NO. 03 - 0178 DATE ISSUED Z -/9-(/3
CONTRACTOR -'3L~On(j)UIS./' PHONE (,12. 2.fO . 537S-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL r~
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
~,
4f-4-
~.
~t
L;i4-
.~,11pd~
1-, til?J 10'0
3 It if' (D0
7-/?-t/e3
.~ t to 0?
~/2-7 /D3
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
FINALS
~ .>//:J/tJt{
. ~#~:.eP .
If:r . A / liI-./() <I
'/,I. " } I
_ ~., 1,;r-/(J r
UNTIL ABOVE/ HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
ADDRESS
1'/300/
DATE
SCHEDULED W tf-
lJ~~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
J [.~I 0
OWNER
CONTI~.
PHONE NO.
PERMI:T NO. 0 g - I '7 S
o FOOTING
o FOUNDATIOiE
o FRAMING
o INSULA TIO
~ FINAL
] SITE INSPEC
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOIDKUP
o SEWER HOOKUP
)rt PLUMBING FINA ~
J4 MECH FINAL
7-~j)
o EXIGRADIFILLlNG
o COMPLAINT
FIREPLACE RI
FIREPLACE FINAL
o GASLlNE AIR TST
o
L-~
L
..
/j/) rj /J
( "( ~t?rrlQ ~,
~ -
1 t I
\/eA4 JJLLc'
./
,)roWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~: Owner/Contre
CALL 447-9850 FO~ TH~ ~E~T IN~PECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUll~ PERSONAL HEALTH &; SAFETY!
INSNOTJ