HomeMy WebLinkAboutHeating Permit 10-1023 DATE TIYE
CITY OF PRIOR LAKE �
INSPECTION NOTIGE SCHEDULED
ADDRESS l �Q
OWNER CO TR.
PHONE NO. PERMIT NO. I �^ 16 ��Z
� FOOTING ❑ PLUMBING RI ❑ EX/GRADIFILLING
❑ FOUNDATION O MECH RI � COMPLAINT
❑ FRAMING ❑ WATER HOOKUP � FIREPLr4CE RI
[J INSULATION O SEWER HOOKUP O FIREPLACE FINAL
❑ FINAL �LUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTlON ECH FtNAL ❑
COMMENTS:
,
p5-Q.. t �
�WORK SATISFACTORY, PROCEED t
❑ CORRECT ACTION AND PROCEEQ � _/
O CORRE , CALL FOR REINSPEGTlON BEFORE C9�N'G
Inspector. OwnedContr:
CAL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� ,:�--, . - � TEMPORAR TE OF ZONING COMPLIANCE � I � ( �
�' �# �' � ; �, � ND UTILITY C NECTION PERMIT
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M�'�'NES��P I White File
2 Pink �„ PERMIT NO. � p_� OZ
3 Yellow Apphcant
Please e or rint and si at bottom)
ADDRESS ZONING (ott'ice use)
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LEGAL DESCRIPTION (of1P'ice use only)
LOT BLOCK ADDITION PID
ovvlvER 9�2 -y�� - 39 7z.
(Name) ��r{,., h �w � S (Phone)
(Address) y/ g t� .�� T�. �
BIJILDER
(Company Name) Z� c��.a Nf �r c�� _�� �e► � �t.�v � c.�* S (Phone) ? 43-2/�J� �g'� 4�
(Contact Name) �� � Cz�� (Phone) � I 2 - 9 � S' -g � 7 �
(Address) ��� � S'i �_ An,-r-� cd ��p �J 3`
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofin e-S�ding o vel Fimsh ❑ Fireplace
❑Addition ❑Alteration ❑Urility Connection
CODE: ❑I.R.C. ❑I.B.C. Misc.
��+-2..� dc..�
Type of Construction: I II III IV V A B �� $
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding an
I hereby certify that I have furmshed mformat�on on th�s apphcahon which �s to the best of my knowledge true and conect I also ceit�fy that I am the owner or authonzed agent for the
above-menhoned property and that all construchon wtll conform to all ex�shng state and local laws and will proceed m accordance with submitted plans I am aware that the buildmg
official can e this permrt for�ust cause Furthe�more, I hereby agree that the c�ty official or a deugnee may enrer upon the property to perform necded mspecaons.
Y �
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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 Permit Fe $ TOTAL DUE $
/
This Application Be rnut When prov d Paid / ReCel t No.
Date B
It p '
Buildm � Uftu. < I � e
Th�s is to cerhfy that the request m the above �canon d accompanying documents �s m accordance wrth the Ciry Zomng Ordmance and may proceed as requestcd Thts document
when s�gned by the City Planner consatutes a temporary Cert�ficate of Zonmg comp(iance and allows construction to commence Before occupancy a Certificate of Occupancy must be
issued
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9550, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372