HomeMy WebLinkAboutBldg Permit 04-1016
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
TIME
SCHEDULED
IO-U-~
ADDRESS /57101 "kU ~ ~
OWNER CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
E..)_NSULA~
~INAL I)
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Db .~ &;
/'
~ORK SATISFACTORY. PROCEED
~ ~'~RRECT AC 'ON AND PROCEED
o CORREC CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owne rICo ntr:
CA
THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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
j571t?4-
/J l fflJO
Y 1(;,-1'1,/ /(/0.
LEGAL DESCRIPTION (office use only)
ft I (),vJ
1::5t. VI f=;L..J S--nt
LOT 10 BLOCK J ADDITION
OWNER
(N ame)
(Phone)
(Address)
BUILDER \ M P fJ' A/'v:. A:J A 1 (. /:) L(
(COmpanYName~J.:.-~ CO"'~r
(Contact Name) l b'()(J Q.b#.~~
(Address) &2fet> ItR-m ~~ c ~,
TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding
OAddition o Alteration DUtility Conn~n 0 Misc.
Date Rec' d
I (1,. 7 ~ 0 'i-'
PERMIT NO. 04- ~ / {; / 0
ZONING (office use)
KAJo
PID U. 2 r2-. t') 7-1) ~ ()
(Phone) /PtU ~ . fJb*
I
(Phone)
OLower Level Finish 0 Fireplace
CODE: DI.R.C. DI.B.C.
Type of Construction: I II III IV V A B
Occupancy Group: ^ A B E F HIM R S U
Division: 1 . \ 1 2 3 4 5
I hereby certi/y~t~\aV4 fi rm hed mformatlon on thiS application which IS to the best of my knowledge true and correct I also certtfy that I am the owner or authonzed agent for the
above-mentl~ned r per~ a_ ~ lat I constructIOn Will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
;"'" ,=, vok t ~ '7~ '" F"rtheemo". I hee,byo",""'" th, "l"f Offi'i~de~n~;:;t;;~n th, ",op,"", to "",form n"d~ ~'PCCl'; 10
~/ F{j' f.gnature Contractor'iUcense No. f Date f
PROJECT COST IV ALUE $
(excluding land)
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
-/~ oc/V
10_ 1.,.fJ 4--
Paid
Date
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
$ '1 b. () ()
,1 '"
ReceiProo 1/-7 J/(, J
By / .
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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. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372