HomeMy WebLinkAboutBuilding Permit 11-0681 TE TIME
CITY OF PRIOR KE
INSPECTION O SCHEDULED Z )) 11
ADDRESS 4' 4/p
OWNER CONTR.
PHONE NO. PERMIT NO. f X--
❑ FOOTING ❑ PLUMBING RI f❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
*EJNAL ❑ PLUMBING FINAL ❑ GASUNE AIR TST
❑ SITE INSPECTION ECH FINAL ❑
COMMENTS: taiF
75QfL 61r-r- pciazt6 -- 4p .
Rosr- - PAL=S
V L/5-i 4 '' ) (�
XWORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT W. A ' FO RSINSPECTION BEFORE COVERING
a/
In spector: L )Aiir - /Contr.
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
rNSroTI
OF PRI% CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE -J d v x
em AND UTILITY CONNECTION PERMIT
* INN 6sett* I white File PERMIT NO . g.
2 ell City 1 / 2 S�f /
3 Yellow Applicant ! / (f/ V
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
g4/(o Cl/ esj,i L 4N NE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER I' , A /2- 3�/8S+
(Name) / r'Iv ' (Phone) 6
(Address) /513/6 / n-ll 4-14._ ff
BUILDER 1161 (Company Name) Zae (`S (Phone) _ g/ 2 2L/2 V3
(Contact Name) !20 6 l � /� /� /, / (Phone)
(Address) /s_6 5 6
<' E/4,,r -/4 I�Dt-�n 4/. t44, !�t24/
TYPE OF WORK ❑ New Construction ['Deck ❑Porch KIRe- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['
Addition ['Alteration ['Utility Conne ton
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $ 3
Occupancy Group: A B E F HI MR S U
(excluding land)
Division: 1 2 3 4 5
I hereby certify that I have tumi h • nformation 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 property a construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
official can revoke this p . �i ause Furthermore, I hereb a: ee that the city official or a designee may enter upon the property to perform needed inspections.
X I./ ?63t7690 6-a7 -i/
"' 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 $ 7 9 7 3
This Application Becomes Your Building Permit When Approved . Paid / 9. 7 1 `
/12. t No. /OS —
Date 7 2'I.
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