HomeMy WebLinkAboutBuilding permit 10-1022 DATE TIME
CITY OF PRIOR lAKE
lNSPECTION NOTICE SCHEDULED � ( (
ADDRESS �p � � �,1 , (�
OWNER CONTR.
PHONE NO. PERMIT NO. � �'" � b�
O FOOTING O PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION O MECH RI ❑ COMPLAINT
❑ FRAMiNG 0 WATER HOOKUP ❑ FIREPLACE R(
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
�. FINAL ❑ PLUMBtNG FINAL � GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL O
COM M ENTS: 1
l Y �
�.WORK SATISFACTORY, PROCEED
O CORRECT ACTION AND PROCEED
❑ CORRECT W K, ALL FOR REINSPECTiON BEFORE COVERlNG
Inspector: OwnedContr.
CALL 447-98 OR THE NEXT lNSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
ursnon ,
oF PRJp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' X AND UTILITY CONNECTION PERMIT
U. �
M��'NES��P I Whne Fde
Z Pmk ��� PERMIT NO. �(� �� Z Z
3 1'ellow Apphcant
Please e or rint and si at bottom)
ADDRESS � � �� T � / / / („ N � % C � � ` j Z�N (office use)
U Ci C� ��,�- v J C/ ��, D
LEGAL DESCRIPTION (office use only)
LOT /�LOCK � ADDITION Pi� 0�, SO(/� PID 2-,,�, O I . O(o S.
OWNER
(Name) (Phone)
(Address)
BUII..DER � ,,!-
(Company Name) C�' � 1 �: i l d' e�S � C (Phone) C9 �� —��/ - 7 33 �1
(Contact Name) �.�/) l.-'C 1°1 A�"7-� ct .� .�"� (Phone)
(Address) � � � r � ,5T �/ �GL�2v i �� 'e `� S� `O 4 y
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing ❑Re-Sidmg ❑Lower Level Fmish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Conn tion ,
CODE: ❑I.R.C. ❑I.B.C. 0 M�sc.
Type of Const=uction: I II III N V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALLTE $
Division: 1 2 3 4 5
(excluding land)
I hereby certify that I have himished mformauon on this appl�cahon wh�ch is to the best of my knowledge true and correct I also cerhfy that I am the owner or authonzcd agent for the
above-menuoned properry and that all construchon will conform to all exisnng stare and local laws and will proceed m accordance w�th subm�tted plans I am aware that the buildmg
offic�al can revoke this p t �ust cause Fu re, I he y a ee that the c�ry official or a designee may enter upon the property to perform needed�spe ions �
X �
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 Permrt Fee $ TOTAL DUE $ 9 �"�
This Application Becomes Your Building Pernut When Approved Paid , 7 S R t No. /�
Date //, �, U B
Buildm � Utticial Date
This �s to certify that the request m the above applicat�on and accompanymg documents is m accordance w�th the Qty Zonmg Ordmance and may proceed as requested. Th�s document
when signed by the City Planner constitutes a temporary Certi6cate of Zomng compliance and allows constracuon to commence Befoie occupancy, a Cernficare of Occupancy must be
issued
Planning Director 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