HomeMy WebLinkAboutRe-roof 04-1151
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/r/RI
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
~MING
o INSULATION
o FINAL
o SITE INSPECTION
COMMEN1S? 17
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DATE TIME
SCHEDULED ~~~~
,
~~r~ L~~e
CONTR.
PERMIT NO. C7~- //s-/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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VWORK SATISFACTORY. PROCEED
/0 CORRECT ACTION AND PROCEED
o CORRECT W5-'Y~OR REINSPECTION BEFORE COVERING
Inspector: rf~ Owner/Contr:
~ALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please type or print and sign at bottom)
ADDRESS
I t ~<6
_ \ 110,((
~- .
LEGAL DESCRIPTION (office use only) ()
LOT Io/BLOCK 'I ADDITION~ti14d
OWNER 5 72
(Name) ue r,)JSSe:.
I~//<ci
BUILDER J }
(Company Name) nY'W5<r
(Contact Name) .M J I<R
3050
(Address)
(5)Jo( ( L&11~
White
Pink
Yellow
File
City
Applicant
Date Rec' d
PERMIT NO. IJL/./ I' ~ I
, f
ZONING (office use)
PID~S- .g/~-t) b 3 -0
~ - 9y(;,- /0/3
(1ooh 11 V1J:nt (Phone) 9'f), -'tq J, -3 >iY;0l-
J (Phone)
(N'tkmn ~5t-. ~ vtJq 1 tJ2AJ ~ ~3 )" ~
(Address)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ba'Re-Roofing ORe-Siding DLower Level Finish D Fireplace
OAddition DAlteration DUtiIity Conne~ D Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have flirnished information on this application which is to the best of my knowledge tme 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
:"""~ "vok IhB p"mil ';;'0" Forth?};;~': ~i~ Offi'i~ ~J' ":3 7 7";f~:'"P'rty 10 pa'orm "<cd; 7;~~SJ ()
Signature Contractor's License No. Date Y
Permit Valuation
~S-O(j
$ 7Lf.; 7'-
$ I'd-S-
$
$
$
$
$
$
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Pennit When Approved
Building Otlicial
Date
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
.-/
Paid 7",-
Date JrP - /0,- OtJ
/
# $
# $
$
$
# $
# $
$
$
I $7~ 0 <J
Receipt ~4'Q t/ d-d
By (;_
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