HomeMy WebLinkAboutBldg Permit 04-1052
~(7/t:f'
.,.29-5.1 ~", fr" .,(l/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE TIME
c:Jy:../as-..2
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
...e-FtNAL 0 PLUMBING FINAL
o SITE INSPECTION. j 0 MECH,.,.-
~OJIIMENJS: 1~C1P (-,/
/Uc."~(Ve-rf r;'c ~reS
~ (rL<-,/ ,~r;4 ~J
/ ~ / e9 c;;) cf '~i~f.'--I
V -
<-)A'~ -2 .n;.I~S' =-/ ~e
Ap.,- /:3.<, -/er :;:rQ~
/1/' ,. /'.
\~~S -s-h~ ~){;O~~9 ~~U~c'
r:>~~-.~ ~ /-e ..~~e.[
1kK#f ~ c..5.4,::;t 4 \
/~4// a{
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL OR 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
Date Rec' d
10. I~* ~4-
White File
Pink City
Yellow Applicant
PERMIT NO. () tj - lo5P-
(Please type or print and sign at bottom)
ADDRESS
Z953 u:7V71;~
~.
ZONING (office use)
,Ie( ~ 0
LEGAL DESCRIPTION (office use only)
LOT )( BLOCK X ADDITION
,,,SfYU/Jtc,' (~U- ~~
I ()
PID Z5'. In, 05Lo 0
OWNER -r"
(Name) ~ I AJ'I?~j
f
e"'htfJJJ1
(Phone) --&5lJ - ill?.. 9 <LJ ~~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch li1Re-Roofing ORe-Siding
DAddition o Alteration DUtility Con~t~n 0 Misc.
OLower Level Finish
o Fireplace
CODE: DI.R.C. DI.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 tl1rnished 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 construction 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 revoke this permit for Just c e rt rmore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
;t.-f.
,
Permit Valuation
x
Contractor's License No.
----1(.,.- "]-Of
Date
~ 5()O~~O
Park Support Fee
#
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
$
$
$
$
$
$
$
$
$
7(,..00
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
SAC
#
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter
Size 5/8"; I";
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
--
Paid '11/J,. ---- }
Date '/0 -- /3 -0 c....
.. - ,
Receipt No. L/';7 ijq /
By !f--
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