HomeMy WebLinkAboutBuilding Permit 11-0097 DATE TIME
CITY OF PR10R LAKE
INSPECTION NOTICE SCHEDULED 2 � � ({
ADDRESS � y 7 � �j-a�r� �`r •
OWNER CONTR.
PHONE NO. . PERMIT NO. � I' q�
❑ FOOT{NG ❑ EX/GRADIFiLUNG
❑ FOUNDATION � COMPLAINT
❑ FRAMING ❑ WATER HOOKUP Q FIREPUICE RI
❑ INSULATION ❑ SEWER HOOKUP O FIREPLACE FINAL
� FINAL ❑ PLUMBING FINAL ❑ GA5LINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: w;,,��,,,�
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTN & SAFETY!
[NSNOTI
oF PRI�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z, 1 l� / J
�' � � AND UTILITY CONNECTION PERMIT
U �
M��'NES��P � Whrte FJe pERMIT NO . �/- /1 D� /
2 Pml. City ( ( � J
3 Yellow Apphcant �
(Please e or rint and si n at bottom)
ADDRESS �„ ZONING (oefice use)
1 ��5 L�Tc:.GZS < t '�c-fC..... '�r=
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION PID
OWNER n
(Name) ��� ��' "�� �� (Phone)
(Address) ��`���
BUII.,DER n �
(CompanyName) t�� 1�--�'�1�`'�'�(�l.N (Phone) Y,\�� �c���
(Contact Name) _�_f��_ (Phone)
(Address) � '��,,,,�� �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Fimsh ❑ Fireplace
❑Add�tion ❑Alteranon ❑Utility Connecnon _ i_ �,,`
CODE: ❑I.R.C. ❑I.B.C. Misc��-�'��'��� v ���"�w���
.�—
Type of Construction: I II III IV V A B l"u9
Occupancy Group: A B E F H I M R S U PROJECT COSTlVALLJE $ J
Division: 1 2 3 4 5
(excluding land)
I hereby cerhfy that I have h�rnis ed mf io hcation wh�ch is to the best of my knowledge true and correct 1 also cerufy that I am the owner or authonud agent for the
abuve-menuoned p pe and at all r cnon wi ' m to all ex state and local laws and w�ll proceed m accordance with submitted plans I am aware that the bmldmg
offic�al can rev is ermit r � c. �se u more, I he by agree that th city official� or a designee may enter upon the property to perform necded ms ecnons
X r�/� �
Signa 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 $
�
This A lic 'o com Your Buildin�'Perntit n Ap oved Paid Re 1 t No.
Date Z �. / B
i' - Z I
Bui ��k�al Date
This is to certify that the request m the above application and accompanymg documents is m accordance w�th the C�ty Zomng Ordmance and may proceed as requcsted This document
when signed by the Gty Planner constimtes a temporary Certificate uf Zomng compl�ance and allows construcvon to commence Before uccupancy, a Ccmficate uf Occupancy must be
issued
Planning Director Date Special CondiUOns, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372