HomeMy WebLinkAboutBuilding Permit 07-0012
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4 ~ L WJ/kJ :/--
OWNER
CONTR.
7,2
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
-F!!~'7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
] White
Pink
Yellow
I PERMITNO.(}/j_()O/~
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ;l-5- 50D-cJOC;-)
OWNER ~
(Name) ...--.......
(Address)
BUILDER
(Company Name
(Contact Name
(Address) (<-r""+ 3:>.0
(PhOne)#O '2- ~~c?
''- i:..--
TYPE OF WORK 0 New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddition OAlteration OUtihty Conne tlOn
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise.
I
E
7%~
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
formation on this applicatIOn which IS to the best of my knowledge true and COlTect. I also certify that 1 am the owner Ilr authorized agent for the
1 construction will conform to allexlstmg state ,1I1d local laws and will proceed in accordance with submitted plans_ I am aware that the bUIldIng
,use Furthermore, I hereby agree that the CIty offIcial or a deSIgnee may enter l pon the propelty to pertl1rm ~pectlons
dO..i ::J. r:. :::JA- 1'-1 f..(()l'
Contractor's License No. Date
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
i Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
Water Meter Size 5/8", I";
Pressure Reducer
$
$
$
$
$
$
$
$
$76 -
i ~;ce~5 d5 b '1
Park Support Fee
SAC
#
#
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
17~_' ~ -:_
:z I ()'1
nuildll1g Ullleial
Date
This l."i to certify that the request in the above applicatH)Il and accompanYll1g documents is JI1 accordance WIth the City Zonmg Ordinance and may proceed as requested TillS document
when SIgned by the CJty Planner wnStltutes a temporary Certiticate of Zonmg complIance and allows wnstructIon to cummence Before occupancy, a Cl'ltIticate of Occupancy must be
Issued
Planning Director
Speeial Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372