HomeMy WebLinkAboutBuilding Permit 11-0032 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ‘.41/4Z--
ADDRESS LIf O (4)40
OWNER CONTR.
PHONE NO. PERMIT NO. J l ^ 32_
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
.FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
/❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: y' 0\i0 MIC
v , , w ,
/WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC OR 1 , CALL FOR REINSPECTION BEFORE COVERING
Inspector � Owner /Contr:
CA • • 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
o PRj CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /
m AND UTILITY CONNECTION PERMIT Z' l
M'A'NESO-0P I. White File
2. Pink City PERMIT NO. / 0 03 Z
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
I/ ) litIcin Pond, - 10 f)()6( 110t
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION P
OWNER - if • r (Phone) �I 0 .--) _ i
(Address) 111 1v t 11 *Lfl PDn t(I prior (A t,
( Name) )l / I �ti� , �� (Phone) ►1 .
�� I c, ii j7�'(/ � �1
(Contact Name) �` J \� ( Phone ) , 40 � �� gr,
(Address) / il P , � . b . . 1 It . _ 1 //
TYPE OF WORK ❑ New Construction ['Deck ['Porch DRe-Roofing ❑Re- Siding DLower Level Finish El Fireplace
❑Addition ['Alteration ['Utility Connection �� ^� �� �I`��� f � re 1���
CODE: ❑I.R.C. ❑I.B.C. Misc. J ` 1
Type of Construction: I II III IV V A B , ` PROJECT COST /VALUE $ it I voo .
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
1 hereby certify that a furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above- mentione• • oper and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can this .ermit for just cause her or , I here y agree that the city official or a designee may enter upon the property to perform needed inspections.
X 1 / 4 , 'f: I'll /1
Signature Contractor's icense 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 DUE (� V $ /
This Application Becomes Your Building Permit When Approved Paid 7 1 R eipt NO. Z 0 °�
Date ! ,. /Z, //
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance 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 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372