HomeMy WebLinkAboutBuildingPermit 11-0818 DATE TIME
CITY OF PRIOR LAKE /�
INSPECTION NOTICE SCHEDULED 1301 /(
ADDRESS 1 65 - 1 Fo..•.kltln,
OWNER CONTR.
PHONE NO. PERMIT NO. 1 1 ''' 816
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
71.FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: 4 voo c
All
60(g,
XWORK SATISFACTORY, PROCEED
❑ CORRECT TION AND PROCEED
❑ CORRE A RK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto / Owner /Contr.
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENT S ARE FOR YOUR PERSONAL HEALTH & SAFETY!
ration
of PI CITY CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
0 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z
.. i AND UTILITY CONNECTION PERMIT •
40.NF 80lf. I White File I
z Pink City PERMIT NO. Y (�,[
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/S77 F4, et, IJ +r ,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER �,
(Name) 6et-le 5 I e Lt1 04 (Phone)
(Address)
BUILDER //�� �_� ` g
(Company Name) 6efie-S & C)4 t, TI (Phone) "` /- ' S 8
(Contact Name) (Toil. TQ�Nri. a 1 . ( (Phone) C61 ^ ?.'15 ao6 c
(Address) f 6 6 0 J f v,: / /-► 1 I'-' Ur1 I
TYPE OF WORK ❑ New Construction ['Deck ['Porch Re-Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Conn tion
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
I 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- mentioned roperty 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 rev this permit f lust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspection.
X g T 3.43 ?di f
Signature , Contractor's License 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 $ 77, 75 This Application Becomes Your Building Permit When Approved Paid Al - i. t No. Kamm
Date 0 ),.3 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