HomeMy WebLinkAboutBuilding Permit 11-0059 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDIlLED � � I �
,._.�
ADDRESS
OWNER CONTR.
PHONE NO. PERMIT NO. I� (
❑ FOOTING ❑ PLUMBING Rl ❑ EX/GRAD/FIL�ING
❑ FOUNDATION CJ MECH RI ❑ COMPLAINT
❑ FRAMING � WATER HOOKUP ❑ FIREPIACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPIACE FINAL
NAL ❑ PLUMBING F'INAL ❑ GASLINE AfR TST
SITE INSPECTION C7 MECH FINAL ❑
COMMENTS:
t . ,�,� s �u.?:�.. �. O -'Qe.�e c�or-
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❑ WORK SATfSFACTORY, PROCEED
� CORRECT ACTION AND PROCEED
❑ CORRECT ORK, CALL FOR REINSPECTION BEFORE COVERING
I nspector: Owne�/Contr
CAL� 447-98 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSNOT!
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oF prtt CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT U��Z 6 � l t
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M�Nxeso'�P � Wh��e File pERMIT NO. 't _ ps �
_ Pink Crtv
3 1'ellow Apphcan[
(Please e or rint and si n at bottom)
ADDRESS ZONING (ofeice use)
1 I�
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION PID
OrWNER � (Phone) ��� ��
(Address) �
BiJII,DER /�
(Company Name) (Phone) ��
(Contact Name) Phone)
(Address) � � Z �
TYPE OF WORK ❑ New Construcnon ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Fm�sh ❑ F�replace
❑Addition ❑Alteration ❑Util�ty Connection �
CODE: ❑I.R.C. ❑I.B.C. .�M�sc. �
Type of Construction: I II III N V A B pROJEC OS /V ��
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5 �
I hereby cerufy tha ve flirnished mformanon on this apphcat�on wh�ch is to the best of my knowledge true and correct [ also certify that I am the owner or authonzed agent for the
above-menuoned rope ry and that all construcuon will conform to all exisUng state and local laws and will proceed m accordance with submitted plans I am aware that the buildmg
official can re e thi ermit for �ust cau e F rmore I h eby agree hat the city offinal or a designee may enter upon the properry to perform necde�ons
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X � -,� 1� � �
Signature Con ractor's License No Date
Permit Valuation Park Support Fee # $
Permit Fee $ "7 S SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1", $
State Surcharge $ s� � J Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechamcal Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ '
This pplication Be mes Your Building Pernut When Approved Paid �, e<. ReCei t No. 0 �
�- Date — ^ �� B
�I� vt�Z6
uildm�_ Uttic�al Date
This �s to cerhfy that the request m the above appl�canon and accumpanymg documents �s m accordance with the Ciry Zonmg Ordmance and may proceed as requested Th�s ducument
when s�gned by the City Planner consututes a temporary Certificate of Zonmg compliance and allows construcuon to commence Befoie occupancy, a Cernficate of Occupancy must be
�ssued
Planning D'uector Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372