HomeMy WebLinkAboutBuilding Permit #12-203 � ❑ � n ❑❑��O❑ � O > y�
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D
o � PR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �. Z 7 2
.. AND UTILITY CONNECTION PERMIT
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'�jpNESp�Ce' I. White File pERMIT NO. Z Z�
2. Pink City /
3 Yellow Applican�
Please e or rint and si at bottom)
ADDRESS ZOI�TING (oFlFice use)
/ 1����� � .�/ � J ��� �� ,,� .•
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LEGAL DESCRIPTION (ofTice use only)
LOT BLOCK ADDITION PID
OWNER M
(Name) /I�G /'/d� (Phone) ��� — _`J'S�,� r 915 �r
(Address)
BUII.,DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III N V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have fumished information on this application which is to the b st uf my knowlcdge true and correct. 1 also certify that I am the owncr or authonzcd agent for thc
abovamennoned property and that all construction will conform ro all existing stat nd local laws and will proceed in accordance with sabmitted plans. I am aware that the buildmg
ufficial can r e this permit for just c se Furthe or hereby agr that the otTicial or a designee may enter upon the property ro perform necdcd mspechuns.
X o� � �
ignature 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 Percnit Fee $ TOTAL DUE $
This Applicarion Becomes Your Building Pemut Whrn Approved Paid Re 1 t NO. s
Date
Buildim� Ut7icial Date
This �s to certify that the requcst in the above applicahon and accompanying documents is in accordance with the Ciry Zoning Ordinantt and may protteA as requcsted. Th�s document
whcn signed by the Ciry Planner consututcs a temporary Certificate uf Zoning compliance and allows construction to commence. Befure occupancy, a Ccruficatc uf Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED el734 l7 ,
ADDRESS (LA 0 l j �c LQ ,- r
OWNER CONTR.
PHONE NO. PERMIT NO. / )_(:)3
❑ 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 AS HoLne 0,-(4)
COMMENTS:
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❑ WORK SATISFACTORY, PROCEED
VCORRECT ACTION AND PROCEED
\
❑ CORREC WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect. i Owner /Contr:
C • i -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
# E REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH do SAFETY!
INSNOTI