HomeMy WebLinkAboutBuilding Permit 11-0108 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ((
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OWNER CONTR. � / O -
PHONE NO. PERMIT N� I I— �(,�
O FOOTING ❑ PLUMBING RI O EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
� FRAMING � WATER HOOKUP ❑ IREPLACE RI
❑ INSULATION O SEWER HOOKUP �IREPLACE FINAL
�FINAL � PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
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❑ WORK SATISFACTORY, PROCEED
` � CORRECT ACTION AND PROCEED
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� CORRE , CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
CA 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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�� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�� �� �� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
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"�,__ _ _� `�' AND UTILITY CONNECTION PERMIT Z � ' (
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'. Whi[e File pERMIT NO . � f , o' D
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3. Yellow Applicant
Please or irn and si at bottom)
ADDRESS � ZONING �or�re �>
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LEGAL DESCRII'TION (ofi'ice use only)
LOT BLOCK ADDITION PID
OWNER ���,� V� 4 - �i�/ L � � �
(Name) .� , J l l l �1�-- (Phone) / � � �'7 7�'_ :� . ��
(Address) �".�"L �- Q�a �('�
BUII.,DER (� p
(Company Name) C��'' �L WIIL—_ 5� ' �^ ' - /�f (Phone) / � � ��� �`7 �(l��
(ContactName) �/�''I('C�i �j�.�,�U.� (Phone)
(Address) � j �? /' �W , �/0� l.Q�C,
TYPE OF WORK ❑ New Construcrion ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addirion �1lterauon ❑Utility Connection
CODE: �I.R.C. �I.B.C. �Misc: ��� ���Q� I
Type of Construction: I II III IV V A B �,�
Occupancy Group: A B E F H I M R S U PROJECT COST/VALLTE S_� ��•
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I ve fumished inf n on this a pfication which is to the best of my knowledge true and correct. I also ceRify that I am the owner or authorized agent for the
above-mentione r and that all ction will form to all existing state and local ]aws and will proceed in accordance with submitted plans. I am awaze thaz the building
official can re ' per ' r just ca Furthefm , I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X � �� .33�05 � �� -�/
Si ture Contractor's License No. Date
Permit Valuation 1 d� � Park Support Fee # $
Permit Fee $ 3� S SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ S p Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ c 4� . Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE L. ZZ , �� $ . �
This A licatio ern s Your Building Permit When Approv a Paid ,� R i t NO.
Date Z ,
Z. z Z / / .
Buildin Officia Date
This is to certify that the re st in the above application and accompanying docume ts is in ccordance with the City Zoning Ordinance and may proceed as requested. This documeut
when signed e ity ner constitutes stemporary Certificate of Zoning com ce d allows construction to commence. Befare occupancy, a Certificate of Occupancy must be
issued.
zZz//
Planning Director Date Special Conditions, if any
24 hour notice for all inspectioos (952) 447-9850, fax (952) 447�245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS �� I `� L�4r�� /�� ���r� ���Gt�
TYPE OF WORK � ��
USE OF BUILDING ��� �4 ,�
PERMIT NO. ��• O �O� DATE ISSUED � zY.- �i
BUILDER t' �, arL.� L, (�,�-s i� - ��� �,� PHON # y�z� zso -8��
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NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
� � � �Lv/�l�jrJC� �' •� , _ � � .. �'� �
: _., .__. � f ,;
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING �'%�
FINAL � �
FOR ALL INSPECTIONS (952) 447-9850