HomeMy WebLinkAboutBuilding Permit 04-0962
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
5: 23, 0 g/
OWNER
3327 YJILD rmf'4f6 (/;:;.rJ
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
4-. Yb?
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
o EXIGRADIfILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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COMMENTS:
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DIJ 8" I 0
771'6 PI 06"
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I
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor:
Owner/Contr:
.cALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
(Please type or print and si2fl at bottom)
ADDRESS
33;>"7
wi II) /!.IlSc.. P,US t-tW
LEGAL DESCRIPTION (office use only)
LOT I hLOCK.3 ADDITION
hi u."",L)J
6~
OWNER
(Name) -rcJ~
(Address) 3"3 ~ 7
'VA-Is/I-
wI'I/) /lafe,s"~ I;;;;f~$" NW
(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Date Rec' d
tf2-~,01-
I PERMIT NO. 0 If" 09(, z-.
ZONING (office use)
J6(
PIDZS: 375. O-z,J?.. 0
9s-z.,- '(~O-d--'7c
TYPE OF WORK 0 New Construction ODeck OPorch Me-Roofing 'M'Re-Siding DLower Level Finish 0 Fireplace
DAddition OAlteration DUtility Connec~~ 0 Misc. r
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST /V ALUE $
(excluding land)
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
x
I hereby certifY that I have furnIshed mformatlOn on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentIOned properry and that all construction Will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
offIcial can revo ermll for cause Furthermore, . by agree that the Clry official or a deSignee may enter upon the propelty to perform needed mspectlllns.
1/;z.Yhc/
, o'bate'
,/ Signature
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
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.~~,
Paid
Date
BlIildill~ Otlicial
Date
# $
# $
$
$
# $
# $
$
$
Ii 1(,..{ 0
ReceiUo. .,.1 i -z, I-
BO'
ThiS IS to certify that the request m the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested TillS document
when signed by the City Planner conSnlutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions. if any