HomeMy WebLinkAboutBldg Permit 04-0977
,I"
DATE mle
/~/7
Yr"'# tthy~U/ &9C/ ~I
CITY OF PRIOR LAKE
lNSPECTlON NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~~-f'77
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/Jf)
// Ii
/Zoo r-
~
,r/i
//~q
,
/
..,
~L
/'
l( WORK SATISFACTORY. PROCEED
/ d CORRECT ACTION AND PROCEED
o CORRECT WOR;~~ REINSPECTION BEFORE COVERING
Inspeclor: I' ~ QwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
Ili$NOTJ
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 Yellow Applicant
lse type or print and sign at bottom)
JDRESS
:s f'~1
WI f.,VtlW J?~1
~.
LEGAL DE.SCRIPTIO~ffice use only~
S64 I tJ' 0 F I rc:t-G-t- ~
LOT BLOCK ADDITION
OWNER
(N ame)
(Phone)
(Address)
BUILDER ) ,-
(Company Name) -~ ~.;U ~Pbf-<; (.ltJJ0
(Contact Name) ~ \ -f(L\b~~" ~ .
!l&zo ~ -Gutuc, 'S I- JJ
Date Rec' d
f'. 2,8,61--
PERMIT NO. O~I()'171
ZONING (office use)
Jet
PID zI: 10/. ~o8... 0
(Phone) q 52 - '-/4, - J <6.s.2..
(Phone)Cf.U- bl2: CqO- SS'sg
(J~ t!L $572
(Address)
J
TYPE OF WORK 0 New Construction ODeck OPorch txlRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Conn~n 0 Misc.
CODE: OJ.R.C. OI.B.C.
Type of Construction:
'cupancy Group: A B
ision:
B
S U
PROJECT COST IV ALUE $
(excluding land)
I
E
II
F
I
III IV V A
H J M R
2 3 4 5
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
:ffiC,.J con "~c tJt:r~n" C~:h^::::-he"b: .gree thot the city n:~ ~';;~'a;; npon the pmpmy to p"ro<m ncode~n:c;:~ _ (j Y
Signature Q Contractor's License No. Date
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"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
'16"W
II ~ ,/1<'
.-I
Paid
Date
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ 1".00
/J
Rece!Str.~up?..
BYO ~ .
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
signed by the City Planner constitutes a temporary Celtificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
:d
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