HomeMy WebLinkAboutBldg Permit 04-0725
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/7~P</ r-rYh"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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40 ~~ -/,~
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4 /? "
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~~RK SATISFACTORY. PROCEED
h'~'ORRECT ACTION AND PROCEED
o CORRECT WOR) JJJPR /. SPECTION BEFORE COVERING
Inspector: pl/f/-' Y Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/749(p S(//1/~
Date Rec' d
7. /(, w c1f
PERMIT NO. 0"'" (J 1 z..-r
(U~
(p(/,,{;~
ZONING (office use)
J!z.r .0
LEGAL DESCRIPTION (office use only)
rtofD '7BLOCK / ADDITION {l.JCXJ d U~ 6< wd
OWNER
(N ame)
(Phone)
(Address)
PID 2..-J. 2z"7,,, 607",0
BUILDER 1"\ \ n /"l -...
(Company Name)-LJQV9 ~ 0<.00 "t-~j JhC~
(Contact Name) D () (Jld I ea. ~ fld.L*~ (Phone)
13'1l{n at) )'-!A &r-A/elA/ Q~c-it (&trd A1)/ S-6o?;A
(Phone) ofJ -J. q ~"I;)~ ~
(Address)
J
TYPE OF WORK 0 New Construction ODeck o Porch \7(Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Conn~-n 0 Misc.
CODE: OJ.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST IV ALUE $
(excluding land)
.<;' nooJ)o
- ,
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
..",.,
. formation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
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
just cause FUlthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
'0-/6 -0'1
Contractor's License No.
l./'
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
Paid '1 ~ .. f/"l,)
Date /. It, ~ r-
~
Building Otlicial
Date
Date
# $
# $
$
$
# $
# $
$
$
~1~.ClC/ 7
~~cei~. q,--tL-ZY
U
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
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any