HomeMy WebLinkAboutMeter Changeout 01-1225
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ZONING (olIk:eusel
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LEGAL DESCRIPTION (office use only)
LOT3BLOCK / ADDmoNf?/J~!JbJ/)ft fSll'
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(Address) ..~
BUll.DER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
-
.; ~ v
I P~t Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(phone)
(phone)
DAddition
ORe-Roofing
0AIterali0a
COSTIVALUE (exdudingIand) S
ORe-SidiJIg
DutilityCODDeCtion
'OD which is to the best of my Imowfedse true.and c:omct. I also cerlilY !bat I am the owner or
c:onstructiOD will confonn to all existing state and loca1laws and will proceed in acc:ordance willi
revolre this pennit for just cause. :; _.:.._~.._, I hereby ..... !bat the city oflicia1 or a designee may
/6k
Contractor's License No. '0...'
$
$
$
$
$ 1-1/1,00
$
1$
I $
I Park Support Fee #
I SAC _ #
I Water Meter Size 5/8(.1;;'Y
I Pressure Reducer
I Sewer/Water Connection Fee #
I Water Tower Fee #
I Builder's Deposit
Other
TOTAL DUE
This AppticatiOD Becomes Your Building Pennit Wben Approml
-
I Paidb' -~U'):- ......
I Date / "" ;:~Ji -(7 f
I Receipt No. L-I,07fo~
Bv(}c- .
U
$
$
$ :::J.e;'n,UJ
1$ I1IJ,OO
$
$
$
I $
I $ 3/"n fY
Building Official Date
.r '\ certify !:bat the request in the above application andoJCCompanying documents is in accordanc:e with the City Zoning Ordinance and may proceed as requested. This document
". ~ by the City Planner constitutes a .-.....~-J Certificate of Zoning compliance and allows construction to ~4__"_. Before occupancy, a Certiftcate of Occupancy must be
iiiied.
Planning Director
Dale Special Conditions, if any
24 hour Doti.e for all inspections (952) 447-9850, fax (952) 447-4245
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Ma.IA. li-o lA 1<cl.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDlA..ED
..
ADDRESS IS/Bo
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE TillE
4:00
'1
'fI1p-.II
1-1;;2.~S;-
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING fE) 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 'Ji()PLUMBING FINAL
o SITE INSPECTIO b MECH FINAL,
COMMENTS: JI'II~ ehzt~o-..:J-:. .~~ r~
p~.
b 1z..-4b9-1/600
Q5z - L(c.( 7- 7 Z-3<s.
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o F PLACE FINAL
SLINE AIR TST
-::
~
~WORK SATISFACTORY. PROCEED
b"CORRECT ACTION AND PROCEED
o CORRECT ~LL FOR REINSPECTION BEFORE COVERING
Inspector: ~ .. OWner/Contr:
I
CALL "7.9860 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
INSNtm
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!