HomeMy WebLinkAboutBldg Permit 04-0917
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/Pu-e
ADDRESS
/by92
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~AL 0 PLUMBING FINAL
o SITE INSPECTION /'J.D MECH FINAL ()
COMMENTS: /~ e /"00 1/
/J /
0Cfr,,-. ~
r-JCe
DATE TIME
r~~~y
~~ #tA!-.
cJlL' - 9/7
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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d~~ ~ ~C- -/;~
if /J -
~t:1.,6 fL a ,;1~ 't' e;- ".1 c:> t1.:
~p~ ~~ 9'y~~d
, /'
hRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, C:;;- ~O~7SPECTION BEFORE COVERING
Inspector: jr 1/Cf5i(. Owner/Contr:
v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
l/VSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9. 13~ () l'
I. White File
2 Pink City
3 Yellow Applicant
PERMIT NO. d+. () 9/7
(Please type or print and sign at bottom)
ADDRESS
IC, ~1 z
PlJ/G j#1W)CS
/eL) .
ZONING (office use)
If z.s ()
LEGAL DESCRIPTION (office use only)
LOT X BLOCK X ADDITION ~~J I OE t;r.,;;TES
PIDZS. 183. d/8~o
OWNER
(N ame)
(Phone)
(Address)
~~~~~Name) R<A'V\._o~~ ~5-~4 (1 [~(~~~nS'1. (Phone) ~.fS;j- P9J -(;n/r::
(Contact Name) POL,"") 6!.J1 <\ (Phone)
(Address) /8:l~/~? a~~ ~ . Ii.,te- ,/~ ~~/~ / -//Y) ~
TYPE OF WORK 0 New Construction ODJ. o Porch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection D Mise,
CODE: DI.R.C. DI.B.C.
Type of Constmction: I
Occupancy Group: A B E
Division:
I hcreby certifY that I have flJrnished mfor
abovc-mentloned property and that all c
official can revoke per or just
II III IV
F H I
1 2 3
A B
R S U
5
PROJECT COST IV ALUE $
(excluding land)
i is to the best of my knowledge true and correct. I also certifY that I am the owncr or authorlzcd agcnt for the
I isting state and local laws and will proceed in accordance with submitted plans. I am awarc that the building
that the city official or a designee may enter upon the property to perform needed mspcctions.
Contractor's License No,
cP -1,3 -0'/
. ,
Date
x
This Application Becomes Your Building Permit When Approved
Paid 7 ~.() 0 ~
Date 9. /::1" Q f-
/1
II
~NO.
$
$
$
$
$
$
$
$
$
7b. ()()
,
n?r~
,
Permit Valuation
Permit Fee $
~mCh~kF~ $
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"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
Building. Otlicial
Date
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 requcsted. This document
when signcd by the City Planner constltutcs 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