HomeMy WebLinkAboutBuildingPErmit 10-0517 DATE TI61E
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 9� l
ADDRESS 1 �c�O I •
OWNER CONTR.
PHONE NO. PERMIT NO. ID �s� �
❑ FOOTING O PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATI N � SEWER HOOKUP ❑ FIREPLACE FINAL
�-FINAL �� � O PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
� S �
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
O CORRE WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect : OwnedContr:
C -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH dc SAFETY!
�NSxort
oF PRI�� CITY OF PRIOR LAKE BUILDING PERMIT, D ����a�'� �'
,� , �, TEMPORARY CERTIFICATE OF ZONING COMPLIANC
�' ',� AND UTILITY CONNECTION PERMIT JUN 1 6 2010
M�'�'NES��P I Whrte File pERMI
2 Pmk C�ty
3 Yellow Apphcant �
�(Please e or rint and si at bottom)
�
ADDRESS ZONING (ot�ice use)
I ��0 �� ✓0 6� �tV� N
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ' n/ � d
(Name) � I�i�N��� �' -- (Phone) - ls�" � �5' � � �� - -
(Address) ��j�j� � �(/QU � -��/� � G
BUII.DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction �Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addiqon ❑Alterat�on ❑Utiliry Connection
CODE: �.R.C. ❑I.B.C. 0 M�sc. � c���� r� •
Type of Construction: I II III IV V A B pROJECT COST/VALLTE $
Occupancy Group: A B E F H I M R S U
(excluding land)
Division: 1 2 3 4 5
I hcreby certify that 1 have h�rnished mformat�on on this apphcahon which is to the best of my knowledge true and correct I also cert�fy that I am the owner or authonzed agent for the
/ above-mentioned pr perry and that all construction will conform to all exishng state and local laws and will proceed m accordance with subm�tted plans. I am aware that the bmldmg
� ` ufficial can revoke � rmrt for�ust cause Furthermore, I hereby agree that the c�ry official or a designee may enrer upon the property to perform necded mspect�ons
a X
Signature Contractor's License No. Date
Permit Valuation �� �� Park Support Fee # $
Permit Fee $ $$� Z SAC # $
Plan Check Fee $ Water Meter Size S/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 DLTE $ l� I
This Appl' 'on omes Your Building Permit en Ap oved Paid Recei t NO.
� � � � Date B
Bw �� Utticial Date
This u to certify that the uest e a ve �ptication and accompanymg docu ents �s accordance w�th the City Zonmg Ordmance and may proceed as requcsted This document
when signed b City nner consht es a temporary Certtficate of Zonmg co pliance nd allows constructton to commence Before occupancy a Ccruficau of Occupancy must be
issued
� 1 �
ning Director Da Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS � l ��O � � r�b I �.�-
TYPE OF WORK ��i� �- 2 - �-
USE OF BUILDING /�
PERMIT NO. (� ' S� 7 DATE ISSUED lo rv � e�
BUILDER ��-� LQ� PHONE # ��z.. �(-�o��
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING WC � �,,(, W
PLACE NO COI�CRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL �i z i
FOR ALL INSPECTIONS, (952) 447-9850
:�