HomeMy WebLinkAboutBuilding Permit 09-0223
CITY OF PRIOR LAKE
INSPECTION NOTICE
_ rTE / TIME
,_ SCHEDULED y'z.' lor r : 30~
::s crCos Rrzs [T(/V0
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
b I ., ZZ '3
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULAJjON r... 0 SEWER HOOKUP
~INAL I-L-a:;>r' {'~D PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
~O/C- j=-/A/tC
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
C.LD~PII.6
Pl-WORK SATISFACTORY, PROCEED
o CORRECT ACT'uD PROCEED
o CORRECT ;W~.K C LL FOR REINSPECTION BEFORE COVERING
Inspector: ~ J - Owner/Contr:
~ - .
.CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
(Please type or print and si~n at bottom)
ADDRESS
3Q6S
CITY OF PRIOR LAKE BUILDING fERMIl,
TEMPORARY CERTIFICA TE OF ZONING COlWPLIANCE
AND UTILITY CONNECTION PERMIT
White File
Pink City
Yellow Applicant
Pe r~k..'''')
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<;w
. f r~r L~-b fltv
I I
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
OWNER
(N ame)
<).h.v L. 0 }r I't\
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
ADDITION
(Phone)
(Phone)
(Phone)
- /
o New Construction ODeck OPorch ~Re-Roofing
DAddition DAlteration o Utility ConnrtI~
o Misc.
TYPE OF WORK
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
A
D~te R~~' a
5". /2. OJ
PERMIT NO. 09,0],2.3
ZONING (office use)
pm
q SJ- ,",'TO - J la-I
ORe-Siding OLower Level Finish
o Fireplace
B
I
E
U
PROJECT COST IV ALUE $
(excluding land)
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S
I hereby certify that I have hlrmshed mformation on this applicatIon which IS to the best of my knowledge true and correct I also certIfy that! am the owner or authOrIzed agent for the
above-mentlOned property and that all nlOstruction WIll conform to all eXlstlOg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
ot1lcia! c 'voke this permll for Just cause Furthermore. I hereby agree that the CIty official or a deSIgnee may enter upon the propetty to perform needed lOspectHlns.
x
-~
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Signature
Contractor's License No.
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
SewerlWater Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
-;cP. C/V
S,/2. a:I
I
Huildlllg Ofticial
Date
5 - po. -Q 4
Date
# $
# $
$
$
# $
# $
$
I $
...I $ 7&.00
Re~No. b 119L-
By L
0
ThIS IS to certify that the request m the above applicatIon and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate OfOccllpancy must be
issued
Planning Director
Date
24 hour notice for all inspeetions (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any