HomeMy WebLinkAboutBuilding Permit 10-1006 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED S/ 1ff
ADDRESS t (3 pR ` W -! F�-,L
OWNER CONTR.
PHONE NO. PERMIT NO. 70- -- (C0
❑ 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: T
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SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRE ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CA -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
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PR CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
y TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / / Z /�
x AND UTILITY CONNECTION PERMIT
4 /NNESO,0. I. White File PERMIT NO /
2. Pink City / 0 / O O 6,
3 Yellow Applicant !!!
(Please type or print and sign at bottom)
ADDRESS _ ZONING (office use)
11 13 0 w,+ s 01-e∎ % - � � ( P �
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER A „� ,1
(Name) fT / 6 N W't1 PI Po ' f `t--I (Phone)
(Address)
BUILDER _
(Company Name) 3 c 'Zit C ay.? 2 `” / v-- (Phone) 6/ Z - 7/ k' G / 0-2 --
(Contact Name) 5E PF (Phone)
(Address) (7941 (7941 ! a / a-) wt1 t ~ S 7 j04.404-r-- /11N 5 Y -- Z- ----
TYPE OF WORK ❑ New Construction ['Deck ❑Porch e- Roofing :Me- Siding ELower Level Finish ❑ Fireplace
❑Addition DAlteration ❑Utility Conne do
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
(excluding land)
Division: 1 2 3 4 5 1
1 hereby certify that I have 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. 'perry and th. .11 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 revo p•- mit : just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins •ctions
x
011 /lri /2-0 1. 112/0
�' Signature Contractor's License No. 1 7ate
Si g
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 I $ Other $
Gas Fireplace Permit Fee $ i TOTAL DUE $ 1 9 7 .
This Application Becomes Your Building Permit When Approved Paid 7 / •r eipt No. (0/6,6
Date `/. 2 _ 1 B
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