HomeMy WebLinkAboutBldg Permit 04-0833
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
L-J/"Ji
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o JNSULA TION /"
%" FINAL <..r~
o SITE INSPECTION
COMMENTS:
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DATE TIME
:,. 127.dLj
fr.ra ~ t-u:;o cl' C /Y
SCHEDULED
CONTR.
PERMIT NO.
L{ -?3 3.
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W?,?RK' C FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
V
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTI
(Please type or print and sign at bottom)
ADDRESS
4/3/
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
B,lrof-
White
Pink
Yellow
PERMIT NO. Of, Of; 33'
File
City
Applicant
(SeAl Iv' NtlaO
ZONING (office use)
(1,,1 f<- N6
Je1S0
LEGAL DESCRIPTION (office use only)
LOT ~LOCK;\' ADDITION
\~r\io V u~
\':t~.., {I? n ~w ?('~ l(~(- ~\~I "~
TYPE OF WORK D New Construction DDeck DPorch ~e-Roofing \iRe-Siding DLower Level Finish
DAddition o Alteration DUtility Conn~~ 0 MiSC'?'-WFiI!f1' .rl.o/ Nt:;
CODE: OJ.R.C. OI.B.C. PROJECT COST/VALUE $
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F H J M R S U
Division: I 2 3 4 5
OWNER
(N ame)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
x
PID es. 032.., 010" 0
(Phone)
(Phone) _(", \'1 ~ ~ ~~ 'O~ 0 ~.
(Phone)
{\Q.-w r rf\s.) L~~
o Fireplace
I hereby certify that I have filrnished information 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
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
:".1 con "voke 'h~: J~'('" ~U:h= h"'by 'gl" thut the e'ly offle,.1 0' · d,,'go" may",", upon the pmpetty '0 perloon needed :;70~~ I 0 1-1
. - Signature - Contractor's License No. Date
H 7(,. W
BlIIldlllgOtliClal Date i;::e 1 ;:/::~/ J ~~(f~' "75"~7
ThiS IS to certtfy that the request m the above appltcatlOn and accompanymg documents is m accordance with the City Zonmg 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
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Z, 5l) 0 "CJ()
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 Permit When Approved
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