HomeMy WebLinkAboutBldg Permit 04-0996
DATE TIllE
CITY OF PRIOR LAKE /9/}2fyl
INSPECTION NOTICE SCHEDULED
ADDRESS /h5:J? ~~ ~~
OWNER CONTR.
PHONE NO. PERMIT NO. o~-?Pd
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXIGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING AL 0 GASLlNE AIR TST
o MECHFI L ~ 0
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/
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT 7?ffFOR 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!
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White
Pink
Yellow
File
City
Applicant
I PERMIT NO.4-t10
16
ZONING (office use)
D
LOT 5" BLOCK (
ADDITION
'2& ~ 1?_J
LEGAL DESCRIPTION (office use only)
(Phone)
(Address)
be
BUILDER
(Company Name)
(Contact Name)
(Address) J ~
~l/wtdt.A/Pb ~ L/!:)pJ.sr~I/'-r~&.rC/
::r,4~O,;U s tMM ~lrlIb
5tPLI117 "SuTTO,V 64kr L (/<'~
(Phone) 95':7. - '-j/j';l - ~o tJ {}
(Phone) 'SA - ~ j1 ~ -- SRI? /J
AtU ~ S-s
TYPE OF WORK. 0 New Construction DDeck OPorch l)JRe-Roofing ORe-Siding DLower Level Finish
J OAddition o Alteration OUtility Connection 0 Misc.
CODE: c1I.R.c. DI.B.C. PROJECT COST IV ALUE $
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
o Fireplace
#tg~
I hereby certify that I have hlrnished 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
official can revoke this er for 1I Ise Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed Inspections.
1t!J/Y'f;~
ate
x
';)t)D 99"9) 3
Contractor's License No.
Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
I ~~~ ~t(~ Receipt No.
By
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 requcstcd. This documcnt
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
Scott County
Page 1 of 1
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This drawing is neither a legally recorded map nor a
survey and is not intended to be used as one. This
drawing is a compilation of records, information, and
data located in various city, county, and state offices,
and other sources affecting the area shown, and is to be
used for reference purposes only. Scott County is not
responsible for any inaccuracies herein contained. If
discrepeancies are found, please contactthe Scott
County Surveyors Office.
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October 4, 2004
http://www.co.scott.mn.us/servlet/com.esri.esrimap.Esrimap?ServiceN ame=overview&Client V ers... 10/4/2004