HomeMy WebLinkAboutBuilding Permit 11-0096 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ��
ADDRESS �' t.rs5�� �Pi 2�lYl
OWNER CONTR.
PHONE NO. PERMIT NO. I 1 -��(p
O FOOTING O PLUMBlNG R! O FJUGRAD/FILLING
❑ FOUNDATION 0 MECH RI ❑ COMPLAINT
❑ FRAMING O WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
f�-FINAL � PLUMBING FINAL ❑ GASLINE AIR TS7
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: �
� a
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC W RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 44 - 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETYI
ursHOn
oF pRl°� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
F � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z_ �� ��
" AND UTILITY CONNECTION PERMIT
���'NESO
i wnn� F;i� pERMIT NO. � l U U �
2 Pmk Qry
3 Yelbw Apphcant
lease or rint and si at bottom
ADDRESS ZONING (otTice use)
L i z� � U;�c� SE
LEGAL DESCRIPTION (o�ce use only)
LOT BLOCK ADDITION pID
�, � ►
( �C Q'� i��L �n/���SjAv`1� � �rt°d� �g �1C> (Phone) �� 1??1 32� — �� d
(Address) a� � I c ,� p r — � 0 1�
BUILDER
(Name)��rf �r�C�,nS'�'ru c_�'{�r,,., [a„n,�,�,toc Ll_� (Phone) ���' �
(Contact Name) A n d r�� J��. �.i�„ 1�. (Phone) `�6 �- �i8 �- 6��S
(Address) 1 � n� � � �'V IL.) SS3�p
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch �Re-Roofing ❑ReSiding
c �
❑Lower Level Finish ❑ Fireplace OAddition �Alteration ❑Utility Connection
��
❑ Misc. S r le �'Oa PROJECT COST/VALUE (eXCluding land) S
I hereby cerafy that I have fumisLed information on this application which is to the best of my Imowledge uue and correcc. I also certifp diat I am the owaer or
authorized agent for the above-mendoned properry and that all construction will conform to all existing state and local laws and wi(t proceed in accordance with
submitted pians. I am awaze that the building official can revoke this permit for just cause. Furthermore, I hereby agee that the ciry of6ciat or a desigue may
enter upon the prope needed inspections.
x , a�6�6�3d a/�W/I)
Signatwe Contractor's License No. Daoe
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ City SAC and WAC # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE a 9, 7S
This Application Becomes Yoor Building Permit When Approved Paid 7! R ei t NO. G(� (p
Date •6 (
Building Official Date
This is to catify that the request in the above application and aocompanying documenu is in accordance with tNe City Zoning Ordinance and may proceed as requested. 11tis dowmrnt
when signed by tt�e Ciry Planner consfitutes a temporary Certificate of Zaning comphance and allows construction to wmmence. Befa�e occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notfce for all inspections (952) 449-�50, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 553'72