HomeMy WebLinkAboutBuilding Permit 11-0669 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /3l / Z
ADDRESS 5 b 6 c j�
OWNER CONTR.
PHONE NO. PERMIT NO. / f - (06
❑ 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
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: A
( . �
if WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: A lir Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Z 4 e i P R 10
CITY O F PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
`�'NES�
1. White File PERMIT NO . // ��
2. Pink City ' w (�/
3. Yellow Applicant / [ e J/ /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
. 1
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER // L i. 1 7 - � - �ltI�)
(Name) A d�� ( / (, 7_ (Phone) 1 ` 7 /�
(Address) » j 1 7 I0 �IY° c ��1 ( c t 1.1 /17
BUILDER G , L/
(Company Name) /G�l w� l ,e�' ecYclkY�6 (Phone) ` 52 � � ` � 9
(Contact Name) ° vi Sr 11 fr,--, t' d i (Phone) `376T 3 C' / ` / gr
(Address) ( 's ye 1 [OL 01 e :),,,,,V i(_? H . A ve
TYPE OF WORK ❑ New Construction ['Deck ❑Porch We- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
DAddition DAlteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B �� i j'
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ L G .
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 - mention d property and ta ll construction will conform to all existing state and local laws and will proceed in accordance with s ubmitted plans 1 am aware that the building
official can re oke this pe 't f t cattle. Furthermore I hereby agree that the city official or a desig may ente the property t needed i n s p 'o
x yr ZG 1 775/ �s
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 $ /79 71 '
This Application Becomes Your Building Permit When Approved Paid 1 C r r Receip . 6 3.1-3 J
Date - 7., ti ( 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 S.E., Prior Lake, Minnesota 55372