HomeMy WebLinkAboutBldg Permit 04-1080
DATE
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A-'F1NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: /J /'
/4/'0" f-
TIME
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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Jzf WORK SATISFACTORY, PROCEED
/d CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
(Please type or print and sign at bottom)
ADDRESS A-
157)6 -r
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3 Yellow Applicant
Date Rec' d
1(/, z"d*,O~
PERMIT NO. 04 ~ 1080
fiJI,' ,4r. ~
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
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PID ~* '1:?'..o52-. 0
OWNER
(N ame)
(Address)
(Phone)
BUILDER '.J · Vi .
(Company Name) C C~ ra \ Yl Cl ~ ~ re V"'" CJ V~)
(Contact Name) Ie rt' Y 5 e V'rSor,
/
(Address)
ZONING (office use)
etJO
(Phone)
(Phone)
7S-Z ~ 4~~- 8(,;58
/
TYPE OF WORK 0 New Construction ODeck OPorch lI!Re-Roofing ORe-Siding
DAddition DAlteration DUtility Con~tiO'n D Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
OLower Level Finish
I
E
fillV V A
HIM R
2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
x
I hereby certify that I have fi.lfnished 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 cgnstruc. n 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 revo . per . ;~. :! - ithermore. I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
Ie> /z: C/ /lP C/
,
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
fi
F
1
B
S U
Signature
Contractor's License No.
$
$
$
$
$
$
$
$
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 Permit ~en Approved
Paid
Date
-J". r/l) _
II. 'UJ"O ~
Recewt No.
B~
U
Building. Otlicial
Date
Date
$
$
$
$
$
$
$
$
$ '1(P.OO
,
4'7,.tQ4!j'
ThIS IS to certify that the request in the above applicatton 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