HomeMy WebLinkAboutBuilding Permit 10-1102 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 3�? (1
ADDRESS � � � � S W ��rflQT1/�J� � �
OWNER CONTR.
PHONE NO. PERMIT NO. lO '" j I� Z
O FOOTING � PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION O MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER NOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
�--fINAL 0 PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL 0
COMMENTS: (/K�2t�
C��- �
� s
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�,WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WO CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
WSNOTI
oF Prti CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, ` ::. �,. � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� ' ° ' AND UTILITY CONNECTION PERMIT
v ;'T
��n'NES��P ����h„r File pERMIT NO. �,� !� �
z r�„G c���
: A'ellow Applicant V .�"
(Please e or rint and si n at bottom)
ADDRESS ZONING ��,re�< <„��
/ �17.s �� I��n�ss �, IS
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID „2� , 3�J . 0 I 3 �
OWNER `- h
(Name) � � �� I"l � U-1�1�- (Phone�O�v� -ao3 ' �"��� d"
(Address) T 7 f � liC/� ld-e,f�/f PSS �'��� ` If
i BUILDER `
(Company Name) � �Q4 �O�r I✓� (Phone) (o !�_ ��3 —���
� (Contact Name) ��1.�-h✓t.a (Phone) QS !$—' 7o1-a�
(Address) '��Q � ( 5 ( 0 ►� �j � �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch �e-Roofing ❑Re-Siding ❑L.ower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connechon
CODE: ❑I.R.C. ❑LB.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $���J✓ �
Occupancy Group: A B E F H I M R S U I
� Division: 1 2 3 4 5 (excluding land)
�
1 hcrcby ccrtity diat 1 havc hirnishcd mformatiun on this applicatiun which is tu thc bcst uf my knuwlcdgc true and corrcct. 1 alsu ecrufy that I arn thc uwncr or authonud agcnt ti�r [hc
� abuve-menuoned properYy and that all cunstructiun will cunfurm to all existing state and local laws nnd will proceed in accordance witl� submiucd plans. I am �iware that thc builAmg
utficial can � uke this' perml[ for just cause Pur icr o�e, I herehy agree that the city official ur a deslgnee may enter upon the pruperty tu perfi�rm necded mspecuuns.
, X / 7� � --- �� � 3 �l ! d
Signature Contractor's License Na Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/S"; 1"; 5
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 DUE $ �( /�
This Application Becomes Your Building Permit When Approved Pald �` ReCei t No ±�,
Ddte � � ( (.' B
� Buildins Ufticial Dt�tc � �
This is tu certify thlt thc requcst in the abuve applicauon nnd necompanying documents is m accordance with the Ciry Zoning Ordin;mce nnd may prucecd as requested. "1"his ducument
when signed by the City Planner consututes a temporary Certificate uf Zoning compliance and allows cunstruction to eummence. Befure uccupancy, a Ceruficate uf Occupancy must be
issucd
Planning Director Date Special Conditions, if any
?J hu�n� noticc for all inspections (953) �147 �)R�O, fax (')�3) �1�7-�2��
4646 Dakota Street Prior Lake, MN 55372