HomeMy WebLinkAboutBuilding Permit 07-0572
DATE TIME
f)-I -u 7
'FC0Jl- C-ycck-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
IGOt-fL{
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t PLUMBING RI
MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~
--.--
~
4 / ~\/
(( ~ V'"J(
------
--
7-57.2
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
5/d,VlV)
~
(./" )
r / j./
v~
"WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
1 nspector:
vvP
Owner/Contr:
,CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERuJllCATE OF ZONING COMPLIANCE..
AND (, II.l..ITY CONNE\...IION PERMIT
Date Rec'd
~. F:t Sica.. I PERMIT NO. 01. 6 tJ 1 z- I
L /jJj [A
(Address) /b 0 yC( z:o~
=--".: Name) -r;,.J-,,;{ R; t!J L J; et 5 (;ft 11 <; Ie (, fJhrJ:v (Pho",,) -:H> ~ - 3.:> '(- 2'if ~ ,:?"
(Contact Name) ":f/\.P ..-"'" K od t< I d LI ~ '"Z- (Phone) 7 (7"7 - "35"0/' - c. ~Cf" cf
(Address) CJ)' 0 f)-j;r....., /-h.v l.:J I I () C; IA..~ -Z (() S Jt?A-(..~ I uQ A.., J'
- d' . ,....--tl . I /' j/U,A,I b/J Us cz.
TYPE OF WORK 0 New Construction ODedt OPorch ORc-Roofing ~idin&, OLower Level Finish 0 Fireplace
OAddition OAJteration OUtility Connection 0 Mise, ?4 ,e f, 11 / ;? 5'8 t< a f"e. C).:!.
,CODE: oI...C. oI.B.C. PR.OJECf COST/VALUE S / A (J ()
Type of CODStmdioa: I D m IV V A B (excluding land)
Occupancy Group: A B E F HIM . S U
DiYisioa: 1 2 3 4 5
(I'Ieue type or flint ... silD at bottom)
ADDRESS
J bO ljef E';4 II' ff(( t
LEGAL DESCRu lAON (office use only)
Al,1!
:;,
LOT
AoomON
BLOCK
OWNEll
(Name)
( AJ o/' -I-e.
tl'~.o{'
(Phone)
14-1/1
5'
ZONING (ofIice 1IR)
PID l.S, 0 q (p . 05 4- . 0
I bcrcby certifY thaI I have It. ,,:.sr . J formation on this applic:ation which is 10 the best of my knowledae true and.... _... I also certifY thaI I am the owner I" aulhonzcd aJlCnl lOr 1M
above.meDlIVtoned r",r' J 'f'd.... ..' ,~.,' ..:." will coofonn to aU ~:..:".. state and .Iocallaws.and will proceed in ,..,,,:.JIa: with submitted plans. I am awarl! that the buildin&
";'7f[::. L 'Tf/!!;r.'.'-' _......., -i~7;'i-;;;'" .." ~-7"9-: 07
L/.. S'ignature ConlrlCtOr's L".~..",. No. Dale
R....,...:.t Valuation
Permit Fee S
Plan Check Fee S
State Surcharge S
Penalty S
Plumbing Permit Fee S
Mechanical Permit Fee S
Sewer &: Water Permit Fee S
Gas Fireplace Permit Fee S
I Park Support Fee
SAC
WaterMeter SizeS/8"; I";
Pressure Reducer
Sewer/Water C~..",...~on Fee
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
ThisAppI:..,..,.. B..... .sYourBuil4qPmnitWheaA,1" ..
.....
Paid If.;-
Oate / ' 'S'. ,,7
f
Buildint Official
Dale
# $
# $
$
S
# S
# S
S
S
/IS
IR~NO.
BY' '
'-/~~.
~ t..f() flh
u
nus is to certifY Ihalthe request in the above application and a ... ,,".... ying documeDts is in , ~ with the City Zoning Ordinan<< and may .. '. . . . J as requcstcd. This documenl
when sipcd by the City Planner conslit1llcs a.," ,. uy Ccrtilicate of Zoning compliantt and aIJows ...'" IClion 10 COIIlJDeIltt. Belin occupancy. a CctCificate ore .....' ,.j must be
issued
I'Iamtina C'-, ......,
Date SpcciaI Coaditioaa, if IllY
24 hour notice for allluspectiOftI (951) 447-98... fax (~) 447...145
16200 Eagle Creek Avenue Prior Lake. MN 55372