HomeMy WebLinkAboutRe-roof Permit 04-1149
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3D~7
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..JI"FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINA/J
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COMMENTS:
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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~ORK SATISFACTORY, PROCEED
~', ~~RRECT ACTION AND PROCEED
o CORRECT WORK~;;IWEINSPECTION BEFORE COVERING
Inspector: /' P 0/ ~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
AN)} UTILITY CONNECTION PERMIT
Date Rec' d
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(Please type or print and s!gn at bottom)
ADDRESS
While File
Pink City
Yellow Applicant
PERMIT NO. 04- ~ I / ~1
3557
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT (, BLOCK
Z. ADDITION
WIl4/0WS 3~
PID~" 110.010.0
OWNER
(N ame)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) CJ 0 0 I
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(Phone) 95;; -Pv9-~~s-s-c')
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne~ 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
1
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 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 authOrIzed agent for the
above-mentIOned prope~"ty nd that all construction Will conform to all eXlstmg state and local laws and Will proceed m accordance with submltted plans I am aware that the buildmg
offiCial can revoke thiS pejror Just cause Furthermore. I hereby agree that the City official or a deSignee may enter upon the property to perform needed mspectlOns
. II
X ( ~ t - .:r_ ,~ '/" /:> c.J
Signature Contractor's License No, Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # I $
Plumbing Permit Fee $ Water Tower Fee # I $
Mechanical Permit Fee $ Builder's Deposit I $
Sewer & W,\ter Permit Fee $ Other I $
Gas Fireplace"Permit Fee $ TOTAL DUE I $ ~(p.O 0
~o I ./
This Application Becomes Your Building Pennit When Approved Paid '7(,. , CJ ~r .f +-F-
Date J l 't d<<( .
Building Otlicial Date
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 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