HomeMy WebLinkAboutRe-Roof 04-1154
ADDRESS,
OWNER
I:::> 17rJ
DATE TIME
SCHEDULED IIWoc[ A..Ti
,;-;ZC~i'J'
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
CONTR.
PERMIT NO. 0 i.( - {f ~ i..f
o FOOTING 0 PLUMBING RI
o FOUNDATION~ 0 MECHRI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
l)FINAL 0 PLUMBING FINAL
'] SITE INSPECTI 0 MECH FINAL
COMMENTS:~.
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(1~ -'
:,~~~.
r
-~)
14 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: · ~ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/577 0
~fr1~/\/'1
~0-
r' ~.
LEGAL DESCRIPTION (office use only)
_Z's"/al/d V ~
IfL. VI t;:,lA/ 7 ~
qU'-
LOT I BLOCK 2- ADDITION
OWNER
(N ame)
(Phone)
(Address)
~~~~~ Name) ,~ l'- h~ t3r .....-)/1. ( Ll {.o Y'\ (: f _
(Contact Name) Rc! J.~
(Address) 1&;'76 7 / -rfa~('-1 _/4v~
/'1 /
TYPE OF WORK 0 New Construction ODeck VOPorch M~e-Roofing ORe-Siding
OAddition OAlteration OUtility Conn~n 0 Misc.
Date Rec' d
/ I~ I Z-., /J 1-
PERMIT NO. () 4',,1/5'''1-''
ZONING (office use)
!e/J .0
PID z,~. ~" tJU" 0
(Phone) IS-.L - gCJcj - 6 () j \
(Phone)
OLower Level Finish 0 Fireplace
PROJECT COST IV ALUE $
A B (excluding land)
R S U
5
IJ
the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
state and local laws and will proceed in accordance with submitted plans. I am aware that the building
e City official or a designee may enter upon the property to perform needed Inspections.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
ITI IV V
HIM
234
dV; /-60'70
Contractor's License No.
Permit Valuation
Park Support Fee
SAC
Permit Fee $
~~Ch~kF~ $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
Paid lir. VV
Date 11_/2 ~
Building Otlicial
Date
/ / - /.;2 -~o(.f
Date
# $
# $
$
$
# $
# $
$
$
$ 1~'(){)
./
~;~ff
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 aJlows 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