HomeMy WebLinkAboutBuilding Permit 10-0767 DATE TII�AE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED II
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ADDRESS �. � � �T_� r �� �}� , —
OWNER CONTR.
PHONE NO. PERMIT NO. I� "' - /G [
❑ FOOTING O PLUMBING RI O EX/GRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION � SEWER HOOKUP ❑ FIREPLACE FINAL
�FINAL ❑ PLUMBING FINAL O GASLINE AfR TST
❑ SITE INSPECTION „�] MECH FINA� ❑
COMMENTS: ��` ;
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❑ WORK SATISFACTORY, PROCEED
�CORRECT TION ANO PROCEED
❑ CORRE K, CALL FOR REINSPEC7{ON BEFORE COVERING
lnspector OwnerlContr.
CA 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAZ HEALTH dc SAFETYl
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oF PR��� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, , �� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ��. ��
� "�;:. � AND UTILITY CONNECTION PERMIT �
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M��'NES��P 1 White File pERMIT NO. � �.��
2 Pmk City
3 Yellow Apphcant
Please e or rint and si at bottom)
ADDRESS ZONING (ott'ice use>
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LEGAL DESCRIPTION (o�fice use only)
LOT BLOCK ADDITION PID
OWNE /��
(Name) (Phone) � l0 � 2 g�� � ��
(Address)
BUII.,DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing Re-Siding ❑Lower Level Fimsh ❑ F�replace
❑Addition ❑Alteranon ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C.
��s�. W i N� vJ�
Type of Construction: I II III N V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U
(excluding land)
Division: 1 2 3 4 5
I hereby certi t I have fur hed mformahon on this applicanon whuh is to the best of my knowledge true and correct I also cerufy that I am the owner or authonud agent for the
above- ioned roperry an t t all construction will conform to all existmg state and local laws and will proceed m accordance with subm�tted plans. I am aware that the building
o ial can revok this perm�t r st cause Furthermore, I hereby agree that the c�ty official or a designee may enter upon the property to perform necded mspe ons
�
gnature 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 DLJE $ G, �
This Applicati mes Your Building Permit When Approved Paid , R el t NO. /3
Date d
9 r, � d
Bu �� Utlicial Da[e
This �s ro certify hat the request m the above appLcanon and accompanymg documents is m accordance w�th the City Zonmg Ordmance and may protted as requcsted Th�s document
when signed by he Gty Planner consututes a temporary Certificate of Zomng compliance and allows construchon to commence Before occupancy, a Ceruficate of Occupancy must be
�ssued
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