HomeMy WebLinkAboutBUILDING 08-0110 (2)
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
OJ:!SULA TION
~FINAL
o SITE INSPECTION
COMMENTS:
A Jr~
L/ II
SCHEDULED
C'C J-t- Ci r:.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
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5?--l{o
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT W~R~, ~ FOR REINSPECTION BEFORE COVERING
Inspector: J/Vr 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 CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Phone) 9~,t. - a:7q - ~ 60(")
(Phone)
IyV . ~S-33 7-
1 White
Pink
Yellow'
File
('it\!
Applicant
(Please type or print and si,::n at bottom)
ADDRESS
t; t ~ /; IUIa~
Cl~
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) $R/O
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Date Rec' d
3, 1'1. of
PERMIT NO. ot. 0 II 0
ZONING (office use)
PID
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing 'I\1Re-Siding OLower Level FinIsh 0 Fireplace
OAdditlOn OAlteration o Utility Connectlon 7'-
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Mise
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certify that I have I1lrl1lshed mfnrmatl1Jn on this applicatIOn whICh IS tll the best of my knllwlcdge true and CllITect I alsu certlly that I am the owner or authuf\zed agent for the
abuve-mentlllned property and that all cunstructlOn will Cllnform to all existmg state and lllcallaws and will prllceed in accordance with submitted plans 1 am aware that the buildmg
orticial can revoke tlus permIt for Just cause Furthermore, I hereby agree that the Clty official O[ it deSIgnee may enter upon the prope11y to perform needed inSpectIons
X nIh~~.!I/ 4~ 1/. .3~? /off'
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Park Support Fee
SAC
$
$
$
$
$
$
Builder's Deposit
Other
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechamcal Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Sewer & Water Permit Fee
1
i $
I $
TOTAL DUE
Gas Fireplace Permtt Fee
This Application Becomes Your Building Permit When Approved
1" ~ (/11
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/
Paid
Date
lluildln~ Ufficlal
Date
# $
# $
$
$
# $
# $
$
$
/1 $ 7(,.00
1 I
Re~Pt No_ 55Tl7
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ThlS IS to n:rtlty that the request in the abnvi.' applicatIOn and accompanYlOg documents is In accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
\\'hCI1 signed by the City Planner c()n:~tlttltcs a temporary Ccrtlticatc of ZOnIng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
isslIed
Planning Director
Date
H hour notice for all inspections (952) .t.t7-9850, fax (952) .t.t7-.tH5
4646 Dakota Street Prior Lake. MN 55372
Special Conditions, if any