HomeMy WebLinkAboutBldg Permit 04-1079
DATE nME
SCHEDULED ~~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/~~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
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o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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. ~ ~ORKSATISFACTORY, PROCEED
/ d 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.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
2. Pink
3 Yellow
File
City
Applicant
PERMIT NO.cr L/-tO?f
(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT ? BLOCK {ADDITION b.AtJlh~
Date Rec' d
ZONING (office use)
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OWNER
(N ame)
(Address)
S7.&>tJ-€
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(Phone)
BUILDER . J ~ /
(Company Name)-b' 4:' ('\ ( A'''~ fJ S ~ J. /~ - (Phone) 'V r) .-- I 3:r ~
(Contact Name) L e..""L- R ~ L~ ~ ~ (Phone)
(Address) f-W L;"1, c. TV.6',v{J1Li7 ;d7-):C. /CU>. {'C<K-I! /11.: 5 S "3 ?-J
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ~e-Siding OLower Level Fin(;Sh Fireplace
OAddition o Alteration OUtility Connection 0 Misc. r IJ
CODE: DI.R.C. DI.B.C. PROJECT COST/VALUE C... /"r"/()
Type of Constmction: 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
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owncr or authorlzcd agcnt 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 awarc that the building
official can revoke this pe~l~ause Furthermore, I hereby agree that the city official or a designee..may enter upon the property to perform necdcd InspcctlOns.
X ~ ~ l.-r .A:~~1r(..... (1C LA 7C: /_ /0 ,,- dO - ", C/
V" r "' Sigfiature Contractor's Lice~o. . Date .
Permit Valuation .3 5"""CJ 0 Park Support Fee
....::
Permit Fee $ 7Q'75 SAC
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Plan Check Fee $ f'e?- 3::> Water Meter Size 5/8"; I";
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
This Application Becomes Your Building Pennit When Approved
/& ~ --
. 10- C).-O -Cf"
Paid
Date
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ 7&J
Receipt No. L/~?/C;'''/)
By ~.. '
9" -
ThiS IS to certify that thc request in the above application and accompanying documents is in accordance with the City Zoning Ordinancc and may proceed as rcqucstcd. This documcnt
whcn signcd by the City Planner constItutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Ccrtlficate 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