HomeMy WebLinkAboutBuilding Permit 10-1075 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (04//
ADDRESS l 6 1- 15 L i tide_ fku-Jk5
OWNER CONTR.
PHONE NO. PERMIT NO. l6 — (0 7 T
❑ 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:
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❑ WORK SATIS • CTORY, PROCEED
❑ CORRECT • ••N AND PROCEED
❑ CORRE• •I , CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contra
CALL • • 7 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
PR / 0.4
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
0
1.
White n. PERMIT NO.
3. Yaunw , t / 0 . /0 75
(Please type or print and sign at bottom)
ADDRESS 16454 Five Hawks Ave SE ZONING (offrceuse)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Rick Poll_ (Phone)
(Address)
BUILDER
(Company Name) ProBuilt America (Phone) 651 - 770 -9315
(Contact Name) Esther Dahl (Phone)
(Address) 2211 11th Ave E, N. St. Paul, MN 55109
TYPE OF WORK 0 New Construction 0Deck OPoach ORe Roofing ($Re- Siding [♦Lower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.C. Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F III MR S U PROJECT COST/ VALUE S 8938
Division: 1 2 3 4 5 (excluding land)
I hereby certify Thal I have tmnishtd intbrmation on this applica1 cm wtiirch is to the best of my knawle8ge tree and ctnieet. I also certify that I am the owner or arthtnized agent frn the I
above - mentioned property 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 revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x
6 N( — 20356847 11/15/2010
Signature Contractor's License No. Date
Permit Valuation f 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 $ ' 7
This Application Becomes Your Building Permit When Approved Paid / � • ! ceipt No. (e / 7 SS
Date J .1 � . (
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.
m
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372