HomeMy WebLinkAboutBuilding Permit 10-1015 DATE T1ME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ���11 � � _ _
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ADDRESS � �Ju"� ��.p�� ,
OWNER CONTR.
PHONE NO. PERMIT NO. �b -' �O ��
❑ FOOTING 0 PLUM8ING RI ❑ EXlGRADIFILLING
❑ FOUNDATION � MECH RI ❑ COMPLAINT
� FRAMING ❑ WATER HOOKUP O FIREPLACE RI
� INSULA710N ❑ SEWER NOOKUP ❑ FIREPLACE FINAL
FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ StTE INSPECTION O MECH FINAL ❑
COMMENTS: ���
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� WORK SATISFACTORY, PROCEED
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❑ CORRECT ACTION AND PROCEED
❑ CORRECT R CALL FOR REtNSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFiETY!
�vsHOn
04 ert� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, 4 -.:,; � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE t� 3 (�
�' ' � �' AND UTILITY CONNECTION PERMIT
., �� �� : �
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M��'NES��P 1 White FOe pERMIT NO . / / ( J �
2 Pml. City /, V �
3 Yellow Apphcant V
Please e or rint and si at bottom)
ADDRESS ZONING {oFeice use)
I �) S� � � I -�rto�r�,l-e.. � �. . 5 � .
LEGAL DESCRIPTION (oflice use only)
LOT BLOCK ADDITION PID
��WNER� �.� �O�Af ,Ud' 1 � - - - (Phone) /J � ' �a �" Jd �
(Address) �
( �p E y R )��.n�C.�IX.C� � u 1`l�,'���1�7 (Phone) �� � �lQ � � � � �j -
Com an Name
(Contact Name) (Phone)
(Address) � / �� � • "� �� � ' � '� � �� �
T'YPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Le el Finish F' eplace
❑Addiuon ❑Alteration ❑Utility Connection � I n10.G,� 3 ��j0 QQ� � ✓,
� �rc.,+ l
CODE: ❑I.R.C. ❑I.$.C. � Misc. � S a �
Type of Construction: I II III IV V A B pROJECT COST/VALUE $ ,�CJL_1 �-"'
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
I hrreby cemfy that I have turnished mfarmanon on this apphcat�on whuh is to the best of my knowledge true and correct I also ceiY�fy that I am the ownrr or authonzed agent for the
above-menhone operty and that all c cnon will conform to all exisung state and local laws and wilI proceed m accordance w�th submitted plans. 1 am aware that the buildmg
official can revo his permit for�ust cau e F rthermore, I hereby agree that the c�ty official or a designee may enter upon the property to pecform needed mspect�o
X ���� a��io
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ �
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This Applicarion Becomes Your Building Pemut Whett Approved Paid R el t NO.
Date � �, � f B .
Buildm � Ufticial Date
This u to cett�fy that the request m the above applicauon and accompanymg documents is m accordance w�th the City Zonmg Ordmance and may proceed as requested. Tfiis document
when signed by the City Planner consumtes a temporary CertiFicate of Zonmg compliance and allows construcuon to commence Before uccupancy, a Cert�ficam of Occupancy must be
issued
Planning D'uector Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372