HomeMy WebLinkAboutBuilding Permit 11-0752 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 911,1//
ADDRESS 2.1 (3 ( > L V�
OWNER CONTR.
PHONE NO. PERMIT NO. 1 f
1 7S2
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILUNG
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
"-FINAL ❑ PLUMBING FINAL ❑ GASUNE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
0)14e,r1 1 (-2
1 2 Lf-
)] WORK SATISFACTORY, PROCEED
/ ❑ CORRECT ACTION AND PROCEED
❑ CORREC y CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr.
CAL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
WSNOfl
°A PR /
A. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
L AN TEMP ORARY CERTIFICATE OF ZONING COMPLIANCE l
AND UTILITY CONNECTION PERMIT �J I
j NNES ° �
1. White File PERMIT NO .
2 ell City /
3 Yellow Applicant / III
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
7 913 $Pl u G LA PD ,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER (-
(Name) {` I CAC- 1 4 lhZ (Phone) '5 Z - VV S && 'C,
(Address) J A<
BUILDER
Company ' 6 yy d l6 6" 3
(Company Name) ero'r'Mf't hr c Yld�'c�C'� lr�� (Phone) `T ` "
(Contact Name) N'v .l (Phone) c
(Address) ( 8 L' 21 cj wl L -kat_ 13 t o-. C '
TYPE OF WORK ❑ New Construction ['Deck DPorch � QI�L e- Roofing DRe- Sidipg ['Lower Level Finish ❑ Fireplace
❑Addition ['Alteration ❑Utility Conne on
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
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 p and that all co nstruct ion 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 oke permi for just cause. Furt I hereby agre tha the city o fficial or a designee ma enter u pon the prop erty to pe rform n eeded inspect
% .t
73t/3 . "'" -` /- //
xv 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 7J
This Application Becomes Your Building Permit When Approved Paid f Q . 7 f Re ipt No. 616 ,IV
Date . Si ((,, (( 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 S.E., Prior Lake, Minnesota 55372