HomeMy WebLinkAboutBldg Permit 04-0690
DATE TIME
CITY OF PRIOR LAKE rAhlhJ /
INSPECTION NOTICE SCHEDULED 4J~ "7'
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ADDRESS ,/b"7riJ &uF<3S4/r~ ~-e.
OWNER CONTR.
PHONE NO.
PERMIT NO. t::::'J~ - 6~ 5'0
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
O. I INN~S LA TION 0 SEWER HOOKUP
...f:1'1iNAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL ~
CO~MENTS: A ./" 6 . .(. -
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT Lf BLOCK / ADDITION
OWNER 'U_
(Name) rUf\ 'rv\.tLV4~
(~s)
(Phone)
BUILDER /l _ '-:>
(CompanyName)~~\.\\)fr-\W t).'I\. ~.JLS
(Contact Name) J\A \,\.(LV' ~ll..,~IR.l"t
(Address) JH SSS ~ \; P-~ 1l\t~'t 11ll'\-\ '"
Date Rec' d
PERMIT NO.Dtf- 6qt'
ZONING (office use)
k~56
PID 025"-' 9tJ9-0cJl/-"O
(Phone) !3So." ;),SO-7~S-
(Phone) "S/-7)5- J....JL/ +
, R~M.{b{\ ,AA.tJ $',~ ~ ~
TYPE OF WORK 0 New Construction DDeck o Porch ,~~ROOfing ORe-Siding DLower Level Finish 0 Fireplace
DAddition o Alteration DUtility conne~( 0 Mise,
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST IV ALUE $
(excluding land)
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
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
official can revoke this permit for just cause Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed Inspections,
X \V\.c- ~ ~ ~ 4f. ~O-S'~~ \ ~q .., \<8\t)(..\
Signature -- Contractor's License No. Date
Permit Valuation ;;t 5'0 0
Permit Fee $ 7LI'I~
Plan Check Fee $ 1;75
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
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Paid
Date
Building Otlicial
Date
#
#
$
$
$
$
$
$
$
$
$
7~.~
#
#
Receipt No. L/' 7q 1/
By ~
C
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