HomeMy WebLinkAboutBuilding Permit 03-0438
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
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ADDRESS
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OWNER
PHONE NO.
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PERMIT NO.
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D FOUNDATION
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D INSULATION
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D SITE INSPECTION
COMMENTS:
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D PLUMBING RI
D MECH RI
o WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
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D EX/GRAD/FILLING
D COMPLAINT
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D FIREPLACE FINAL
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~ORK SATISFACTORY, PROCEED
o c;9RRECT ACTION AND PROCEED
,P"CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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Date Rec'd
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Please e or
ADDRESS
I_White
2 Pink
3. Yellow
I PERMIT NO. 03- '13 &j
File
City
Applicant
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ZONING (officem,)
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LEGAL DESCRIPTION (office use only)
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OWNER
(Name)
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(Address)
BUILDER
(Name)
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(Contact Name)
(Address)
(Phone)
(Phone)
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TYPE OF WORK
o New Construction
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o Fireplace
DPorch
ORe-Roofing
DAlteration
ORe-Siding
DUtility Connection
DLower Level Finish
DAddition
PROJECTCOST/VALUE (exc1udingland) S
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
DMisc.
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Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Date
Building Official
7...0(51'8'7;
l{ (I (, I 0 ~
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builderts Deposit $
Other $
TOTAL DUE $ 1/<; ,u...
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This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
,
-
-
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS Ig.:l ~lVO"D' (/; ~ w t1+
TYPE OF WORK eI
USE OF BUILDING
PERMIT N~3-,:,-%:r DATE ISSUED V-/~ -,:j
BUILDER (/III; ~+. PHONE #-.!l!II-IJS"'I/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING I ~ I L/ !z:ok
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
l~ I I
I FINAL I tJL;v/' I r; - ~ ~Ch
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850