HomeMy WebLinkAboutBldg Permit 04-0404
1'R(-03-2004 15:23
~~ or .................
ADDUSS
CITY CF PRIOR LAKE
9524474245
P.0V0!
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORAllY \L.aA11Pk.ATE OF ZONING COMPLIANCE
AND \lluJTY CONNE... liON PERMO'
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1 _ n,
l ...._
Il~LPL/ ,S LA h rCI\-V C (('eI t:
P ('(or \ CAl{ t' ~r)
ZONING (olIcI.)
LEGAL DESClL,: "'IlON (offICe Ide only) .-
LOTSSLOCK ( AOOmON //JMdt/~r I~ /
0,., l'h::..
(Name)
(AddltS$)
~her y
li9l 0 L./
h -eaJ 'f
Date R.ec'd
~RMIT NO. (2!:J,. ~O'tJ
PlDdS~ If5' -O~!5"-O
,\lA.Y\ rc~'1 (' I'celf?
(phone) i:t , 7 ; <<() (07 W ~'-_
(.:::' (' l 0 (""
BUlLDEIl 0 I L 0
(Company Name) ,1' \'
(Contaa Name) Cv e iZ ~ () -riD
(Address) l('2C~ Zll{ f (i Sf W ,10trdttn
COM Si ,-/.i. 61. j rotl
i Cd< .p h" '-
.
(phone) U l? L lSZ ()()O~7<)
(Phone) LRlr. z ~"? 0 d'o3
ftt, 1'1 C " v-z
;>- /-...
TYPE OF WORK 0 Net' COIIIInICrioD DDetk [JPorcll ORc.Root!DRe.sicfins' Lower l.e'trd Finish 0 Fifqll_
DAdclilion [JAltcraticm OUtility C, "",. Jon 0 ' .
CODE: OUl.C. OI.I.C. COST/VALUE S 7. Oct"
TyfeofCOIlStIIICtioa: I D m IV V A B (aCW.....,'
OClC'Dplc)' GIoap: A B E F II 1M.. 5 U
D',',,',Il: 1 2 3 4 5
(
infor_llOlllllllllls iIPI/IIC- MlIcIIIIID IbI: lIrtc (If Il\)' tllO ,. . ,.,. 1I1It.... .,'. .', , 11Ilto ~nifY lhIl 1 .m 1hc \I_~ ".. a.rbanxd ... tor lk
I aU COIISltllcllon will ~ ro iIll fIlDIIIlI PIle IIId Iocd LlwlllIII will" " . ..1 in _... ..ka. sum.ciltcf pins. 1 am _lINIC .. bltildiDtl
fI J'" f..nII.", ," '" Illerdrr lIRe liar lite CRY uIIIdII or I....., " ,~_ ftIB uponllle " "" . ' '. ' 141 per"'" II<<*d 1lIIpftl1Oll$. a- '/_ /'v,/
~_._-. ,.:)()~ 47'-172- ~>- c.- C^
StlnDl\R - CoIIltaefDr'51.iCltnH No. D_
dtac I II,... IlInI
I "".I".~ ."./
ial CIII llIb
(lt~
, I
I I /
PenniteValuatioaY-
. Pennit Fee
Plan Cbc:ck Fee
Slate Surcharge
~ky
Plumbing Permit Fee
Mechanical Permit Fee
Sewer.t Water Permit Fe
Ou Firepblc:e Pmnit Pee
s
s
s
s
Parle: Support Fee
SAC
WllerM~ SizeS/I"; I";
PrcssllR Reducer
SewerlWacer Connection Fee
WaserTowerFee
Builder's Deposil
Other
TOTAL DUE
,j:
I:
ThIs Antindoa St. ... Y_ BlIiJ'., PmIIit WIIc.Il A, ," ' ' " I
Paid
Date
.."
t;t~-: 'Lod
'-' ,
811i/dUll!. ot'I'icIaJ
Dille
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s
s
s
s
I:
s
s
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II
l (.\) ; (TO
Receint Nn.1jj, V i.. ~
By7J 1'-'
r
TItt. Ill'" m'iflr rhallIl..nqune IIIlM .lIowappl"'_IIIllKCl "'''',,'' ,d<<awnlJ.inl<<llfdM~wilbdteC"" ~ OrdinallCl! .1l1l1lllY ,,',...~.u rcquna:d. TIIilIIIIC1I~ .
wIIm lipIt:d bJ lilt City "-- eooulll1lln lllalljlt'r.llJ Cc:tlilic:ne 0( Zoallll ~ IIIlI aInwJ COIISIIvCt_ 10 _. Iff OR "<<"'IIIey. . C" "i"". III CkCllJ'lllCY IlIlISt /Jr
...,4
......~
Dele
U 1IoW'1IOlift t/W 1lI1111peC~ MJ) "'.tIN.11I (Pn) 441....J4!i
'''?M Il'ftA'.. ,,__.. , .
Special ~ if..,
... I
TOTAL. P.01
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/7..2br/ Sv""/"y
CONTR,
OWNER
PHONE NO,
o FOOTING
CJ FOUNDATION
CJ FRAMING
o INSULATION
~L
CJ SITE INSPECTION
COMMENTS:
t? ,,/
T~I de
,
PERMIT NO.
o PLUMBING RI
o MECH RI
Cl WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
Cl MECH FINAL
./? 1 /
U:7;e / /e,-, fe...-
jl~~ -
C)~- ~ot/
,
o EXIGRADlFILLING
Cl COMPLAINT
Cl FIREPLACE RI
o FIREPLACE FINAL
Cl GASLlNE AIR TST
CJ
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(/"-r;.r~ h/P
~FACTORy.PROC~
o CORRECT ACTION AND PROCEED
CJ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
~ Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl