HomeMy WebLinkAboutChange in Use Permit 10-0711 • DATE TIME
CITY OF PRIOR LAKE �� � �
INSPECTION NOTICE SCHEDULED /2�//�
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ADDRESS �_� ( � � �`((�� P �',�
OWNER CONTR.
PHONE NO. PERMIT NO. IO '�!/
O FOOTING ❑ PLUMBING RI ❑ EX/GRADIFILLING
O FOUNDATION C] MECH RI ❑ COMPLAINT
❑ FRAMING � WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
�1 SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
4 • ��.. �o �r
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2. [�i _
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❑ WORK SATISFACTORY, PROCEED
� CORRECT ACTfON AND PROCEED
Q CORR RK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto OwnedContr:
C L -9850 FOR THE NEXT INSPECT{ON 24 HOURS iN ADVAPfCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYt
iNSxon
oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� ..g:.° ��<. , TEMPORARY CERTIFICATE OF ZONING COMPLIANCE S 2Q– ��
�' �� ' ' y AND UTILITY CONNECTION PERMIT
U m � �
M��'NES��P � Wh��e Fde pERMIT NO. J/
2 Pmk City
3 Yellow Apphcant �
Please e or rint and si at bottom)
ADDRESS M p � � — ZONING (ot� use>
! `7 � � � �! !/`� �i������ / l V � .
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER '
(Name) � t � (Phone)
(Address) p ��� 5w� ��
BUII.,DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Fimsh ❑ Fireplace
❑Addiaon ❑Alteraaon ❑Unliry Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (exciuding land)
1 hereby certify that I have himished mformahon on this hcahon which is t the best of my knowledge true and correct I also certify that I am the owner or authonzed agent for the
above-menhoned property and that all co ction w conform to all exist state and local laws and will proceed m accordance with submitted plans I am aware that the buildmg
offic�al can revoke this permu for �us u r re, I hereb at the city officia! or a designee may enter upon the property to perform necded mspcctwns
X �� Z`�-/D
Signature Contractor's License No Date
Permit Valuation �QD . O O Park Support Fee # $
Permit Fee $ ��^'�' o O SAC # $
Plan Check Fee $ Z s 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 DiJE $ �. S
This Application Becomes Your Building Pernvt When Approved Paid . Z Cel t NO. lG
Date �, . C
Buddme Ut�icial D1te
This �s to ccKt�fy that the requcst �n the above appUcation and accompanymg documents is m accordance wuh the City Zomng Ordmance and may proceed u requested This dixument
when signed by rhe Gty Planner constrtutes a temporary Certificate of Zonmg comphance and allows construcnon to commence Befoie occupancy, a Certificate of Occupancy must be
issued
Planning D'uector Date Special Conditions, if any
24 hour notice for all inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
August 24, 2010
City of Prior Lake:
I need to obtain a temporary occupancy permit for the property at: 14120 Commerce
Ave. NE, Suite #200, Prior Lake MN 55372. I have a small group interested in renting
the space through November 2010.
Charles W. Puffer, D.D.S.