HomeMy WebLinkAboutBuilding Permit #12-0616 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED �j � Z
ADDRESS c K v �� �'`'' -
' ' OWNER CONTR.
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PHONE NO. PERMIT NO. `'z — � / (o
O FOOTING 0 PLUMBING RI O EX/GRAD/FILLING
O FOUNDATION 0 MECH RI O COMPLAINT
O FRAMING 0 WATER HOOKUP � FIREPLACE RI
- O INSULATION O SEWER HOOKUP O FIREPLACE FINAL
� O FINAL O PLUMBING FlNAL O�3ASLINE AIR TST
O SITE JNSPECTION O MECH FlNAL �
COMMENTS: ��,,o(o,,�, F��k�4_ �-- /�G
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1MORK SATISFACTORY, PROCEED
O CORRECT ION AND PROCEED
O CORRE CALL FOR REINSPECTION BEFORE COVERING
Inspector. Ow�er/CoMr.
CALL 7- 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS.lRE FOR YOUR PERSONAL HEALTH d� SAFETY!
u�or�
o � rtt� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
� �
♦,,� I White File pERMIT NO.
z. rc�► ac I � �
3 Yellow Applicam
Please or rint and si at bottom)
ADDRESS ZONING (ott'ice use>
o? $ o o �0 1� �l,� n /�(/` (,J
LEGAL DESCRiPTION (office use only)
LOT BLOCK ADDITION PID
�a�VNER J �' t' 1 t 5 a U.Q � (Phone) D/ 7- T Q � J
(Address) p� � � � �d �( /� u � ! �
BUII.DER Pella Northland
(Company Name). 15300 25th Ave N. Ste 100 (Phone) �, �y s� G �Y7
(Contact Name) _ plymouth, MN 55447 (Phone) �
(Address) Lic # BC645090 Ph. 763/745-1400 p�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utiliry Connection / �/ �
CODE: ❑I.R.C. ❑I.B.C. �Misc.ynT�� �' �Af/0 Cr00� �P�/Q�//��
Type of Construdion: I II III IV V A B pROJECT COST/VALUE S � �.�� �
Occupancy Group: A B E F H I M R S U (excluding land) `
Division: 1 2 3 4 5
1 hereby certify that 1 have fumished information on this application which is to the best of my knowlcdge true and correct. I alsu certify that I am the owncr or authonzed agent for the
abovamenhoned property and that all onstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. [ am aware that the buildmg
official can revoke this permit for just c se Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform necded ms �•cul�� �//�
/� $� Gy5 a4� �.�
Signamre Conuactor'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 $
This Application Becomes Your Building Perntit When Approved Paid ReCei NO.
Date B
BuilJin � Utlicial Date
Th�s u ro ccvtify that the rcqucst in the abuve applicat�on and accompanying documents is in accordance with thc City Zoning Ordinantt and may proceed as requcsted. ThYs d��cument
when signed by the City Planner consttmtes a tempurary Certificate of Zoning compliance and allows construction tu commence. Befure ixcupancy, a Ceruficate ��f Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (9S2) 447-9850, fAx (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372