HomeMy WebLinkAboutBuilding Permit 11-0826 7 TIME
CITY PRIOR LAKE
INSPECTION TION NOTICE SCHEDULED 5 ' h 3'4
ADDRESS Ib3e7rAgs0c1A /
OWNER CONTR. 1 [4 PHONE NO. PERMIT NO. ■
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
INAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ S TE INSPECTION MECH FItrL ❑
COMMENTS: ° ! - •
47 61afk*-6 0 (
(
CORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT W FOR REINSPECTION BEFORE COVERING
k
Inspector. k �� + er /Contra
CALL 44T -9850 = - ' XT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
o f PRlp CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ,l
x AND UTILITY CONNECTION PERMIT � , , 1'/
ko i NE SO lf . I White File PERMIT NO
2 Pink Ctty ii . rzip
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS 1 ZONING (office use)
/ v 3S DcPd (k)d 9
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER -
(Name) _ Ote 'e5 (Phone)
(Address)
( Name) 5C6. (M ( avd ,_ i (Phone) S7 • -
(Contact Name) c 9 -e cc_ iCe 4. (Phone)
(Address) P`- f , 0 F le e_ 4 I rti
TYPE OF WORK ❑ New Construction ( ❑Deck ❑Porch ❑Re- Roofing Xe-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 A B 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 hav informati• on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above - mentioned pro - t "11 constr cnon 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 tfo.. i, au - +°ermore • • reby agree that the city official or a designee may ent upon the property to perform ed inspections
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 D $ 79 75"
This Application Becomes Your Building Permit When Approved Paid - lg. (• 1 r R ipt No. ('f
Date By ,
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