HomeMy WebLinkAboutBuilding Permit 11-0769 DATE TIME
CITY OF PRIOR LAKE d�
INSPECTION NOTICE SCHEDULED �i_ / __
ADDRESS 7,3 r i ( 5.
OWNER CONTR.
PHONE NO. PERMIT NO. / / • 7601
❑ FOOTING ❑ PLUMBING RI ❑ EXIGRAD/FILUNG
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
X ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: „.
elL.jatis.'
,I WORK SATISFACTORY, PROCEED
❑ CORRECT CTION AND PROCEED
CI E' ' ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto Owner /Contr.
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSWOTI
of PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
L ESO> ) TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ( /' ''
AND UTILITY CONNECTION PERMIT ril t White File i
2 3 Yellow Applicant PERMIT NO. / f 7b
(Please type or print and sign at bottom)
ADDRESS 33 7 / L� lI LSA-� S ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER / !l (Name) L 1 / /T7/ (Phone) 7 4 ( 7 5/ f2
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck ❑Porch ❑Re- Roofing e- Siding ['Lower Level Finish ❑ Fireplace
['Addition ❑Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. •
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U
(excluding land)
Division: 1 2 3 4 5
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 I am the owner or authorized agent for the
above- mention .,.ro. • and that a nstruction will conform to all existing state and local laws and wtll proceed in accordance with submitted plans I am aware that the building
official can pe t cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform ne ded inspections 2 1
\ Signature Contractor's License No. Mug
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 $
.,------1 1
This Application Becomes Your Building Permit When Approved Paid 1 7 C Rec! i t No. /ti «A.
Date /' ( / B •
r
Building Official Date
i
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance a d 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