HomeMy WebLinkAboutDemo Permit 03-0652
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
1. WhIte
2. Blue
3. Yellow
. File
- City
. Applicant
Permit No. 03-()w5'2-
DiRECTIONS
,. DATE
3
BUILDING INFORMATION
7. SIZE OF STRUCTURE
SPACES NUMBERED 1 THRU 10 MUST BE FILLED IN
BEFORE PERMIT ISSUED
(Please print or type and sign at bottom).
8. NO. OF STORIES
C/,c. L
9. TYPE OF CONSTRUCTION
LOT
8LOCK
'0. COMPLETION DATE
PID
ADDITION
c'
4. OWNER (
(Address)
(Tel. No.)
(Tel. No.)
I hereby certify I have
and will proceed in accordance with submitted plans.
Furthermore. ~ agree that the citwficial or a
X /1 ~ ?&~/~
Signature
. ee may enter u 0
FOR ADMINISTRATIVE USE
METRO SAC UNIT DETERMINATiON
MATERIAL FiLED WITH APPLICATION
Cl Site Restoration Plan
o Utility Abandonment Plan
CJ Sewer Abandonment
USE OF BUILDING ;/_
bA/Y\-c::>8' To ee F-Cy>~
Lv Lrlot Wcuse~ AtJ~iT<"J
,
SITE RESTORATION PLAN
CJ Water Abandonment
Accepted by
Rejected by
o Electrical Abandonment
o Other
v
CREDITS
Park Oed. Credit ................................................ $
SAC Credit ......................................................... $
Sewer & Water Connec. Fee Credit .................. $
Water Tower Fee Credit .....................................$
Other .................................................................. $
TOTAL CREDITS ........................ $
-
TYPE OF CONSTRUCTION:
II
III
H
2
IV
R
3
M
4
Occupancy Gr(lup A
B
E
Division
By
Issued by
Date
Date
This is to certify that the request in the above and accompanying documents is in accordance with the City Zoning Ordinance and
may proceed as requested.
City Planner
Date
Special Conditions if any
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATe TIME
ADDRESS
/4958 fJ!.Y16 PI: 6/12....
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
3, C.52-
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
(P ~'Jtt()
:
:
--
[-1 ~J~~ ;/lU:::;;
~
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEEO
o CORRECT W/~AALL FOR REINSPECTION BEFORE COVERING
Inspector: ft/t,t 11 Owner/Contr:
CALL 4.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH of SAFETY/
"'->NoT,