HomeMy WebLinkAboutBuilding Premit 12-0079 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
i
ADDRESS 1 3 9, 42
OWNER CONTR.
PHONE NO. PERMIT NO. 12 — 7 '
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ ITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: 71
_ ' I
r -a
WORK SATISFACTORY, PROCEED
❑ CORRECT A ION AND PROCEED
❑ CORREC WO . , ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
of PR /0� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / 30 / 2-
x AND UTILITY CONNECTION PERMIT
�
'yjNNE SO��' I. White File PERMIT NO /2 9
3 Pink Cpy J�, -
Yellow Applicant /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ 5 3 7 ' A o , cA -/ O-4
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER `
(Name) 0 -ei •/- /1/ 6 c `- i'C-.) IA -- e-- - -/' (Phone) '75 z 7 /J et7` Z e-/7z-
(Address) / 5 3 7 K i. I h p 6 )94 -4- 1(0,._,1
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
/0 - -o
TYPE OF WORK ❑ New Construction NDeck EPorch ❑Re- Roofing ❑Re- Siding ELower Level Finish El Fireplace
❑Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. lSt'S d m
Type of Construction: I II III IV V A B PROJECT COST /VALUE $ / 0 0 0
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. 1 also certify that 1 am the owner or authorized agent for the
above - mentioned property 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 revoke this permit for just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ,„.4.44. �/ /
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; I "; $
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 $ 4/1 7_
This A; li on comes You t ding Permit en pproved Paid .9-/-. �S Recei No. �p6 v ei/
(I � Date / _ 3 0 / Z-- By
Buildin_ Uf' •ia / 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
Scott County, MN
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This drawing is neither a legally recorded map nor a survey and is not Map Scale N
intended to be used as one. This drawing is a compilation of records,
information, and data located in various city, county, and state offices, and 1 inch = 32 feet
other sources affecting the area shown, and is to be used for reference W E ...••••_
purposes only. Scott County is not responsible for any inaccuracies herein Ma Date
contained. If discrepancies are found, please contact the Scott County p
Surveyors Office. 1/30/2012 S CO