HomeMy WebLinkAboutDemo Permit #03-0917
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
PHONE NO.
38/0 /51-771 ~/.
CONTR. P///Pf? / N6i 17) N oe v.
PERMIT NO. 03. oq 17
ADDRESS
OWNER
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 EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
DE-no FINAL-
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( r(.Y olY
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION ~PROCEED
" """""ClV/ L FOR RElNSPECTION BEFORE COVERING
Inspector:, J:/ I J L Owner/Contr:
CALL\f7-9~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~IREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNon
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
1.(/('-<-.- kl'<--? fr-e. ;J/;v;~, IZ<;~ ',-
1. While . File
2. Blue . City
3. Yellow . Applicant
DIRECTIONS
SPACES NU'" Yt.10 MUST BE FILLED IN
BEFORE PE~....p> V
(,,'''''lO'''!'a: and '~) ...,.nom~~~
! 2. JITE ADDRESS
I
\. Y. LEGAL DESCRIPTION
LOT BLOCK PID
Permit No. ~.3 - oc; I 7
1. DATE/7_ rye?]
~/
BUILDING INFORMATION
7. SIZE OF STRUCTURE
8. NO. OF STORIES
9. TYPE OF CONSTRUCTION
25. Q34-. tJ 02- . /
10. COMPLETION DATE
-ADDITION .
/ }4.)iff1~~e)
\ ~/i ~ I;~ (PLfr ..--"L~
5. ARCHITECT (Name)'J (Address) (Tel. No.)
f 1\ / C. !..l-t.- -:- ~/7r- ~ "8<\- 0047
l 6j0NTRACTOR (Name) (Address) (Tel. No.)
'I hereby certify I have furnished information 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.
r f'urtherm07~lbY agree that the city official or a designee may enter upon the prop~t~ ~ ~~m needed inspections.
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(T el. No.)
OFF - ~S' - ~3-48ZS
FOR ADMINISTRATIVE USE
METRO SAC UNIT DETERMINATION
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'(IN ~/1r8)
MATERIAL FILED WITH APPLICATION
USE OF BUILDING
o Site Restoration Plan
(j Utility Abandonment Plan
o Sewer Abandonment
o Water Abandonment
SITE RESTORATION PLAN
o Electrical Abandonment
TYPE OF CONSTRUCTION:
Accepted by
Rejected by
II III IV V
B E H R M
Division 2 3 4
11k
Occupancy Group A
,. f1..0Q
Date
o Other
CREDITS
Park Oed. Credit ................................................ $
SAC Credit ......................................................... $
Sewer & Water Connec. Fee Credit .................. $
Water Tower Fee Credit .....................................$
Other .............. ..... .... ..... ................. ......... ............ $
TOTAL CREDITS ........................ $ t)
Special Conditions if any