HomeMy WebLinkAboutBuilding Permit #12-1224 �, DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED �.- � ��T ' l.�
ADDRESS �' �) - . , �-- " ,7 1 ' �- `�
�� � ��. r �' �"
OWNER CONTR.
PHONE NO. PERMIT Nq. ��� '�� 1"-/
D FOOTING 0 PLUMBING RI ❑ EXJGRAD/FILLING
0 FOUNDATION ❑ MECH RI 0 COMPLAINT
O FRAMtNG ❑ WA7ER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
Cl FINAL O PLUMSING FINAL O GAS}.INE AIR TST
� SITE INSPECTION ❑ MECH FINA� Q� �-- K�`:^ �`��
� ,
COMMENTS: � ` � ' ``
0 WORK SATISFACTORY, PROCEED
❑ CORREC7 AC710N AND PROCEED
� CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ' Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS (N ADVANCE.
CODE REQUIREMENTSARE FOR YOUX PERSONAL HEALTH & StiFETY!
1NSl�'OTI
oF t�xt CITY OF PRIOR LAKE BUILDING PERMIT, �` Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
~ �n'1VES0'� h i. wn��e File PERMIT NO . /��/��(.,�
2. Pink City
3 Yellow Applicam /
Please or rint and si at bottom
ADDRESS �+ i "� L �` �j� ;1 �,� R`i ZONING (oft'ice use>
15��� `' �-
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION pID
OWNER -1
(Name) Jt'�� } �n�b�- �+�/' (Phone)
(Address)
BUII,DER
(Company Name) 13��aKSI�:iY. �hC (Phone)
(Contact Name) �10;^�1 ��� (Phone}
, (Address) ' � M�a�r. k �r. �tW �lJ ; � �� �� r»
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing Re-Siding ❑Lower Levei Finish ❑ Firepiace
�Addition �Alterarion ❑Udlity Connection
CODE: ❑I.R.C. ❑I.B.C. O Misc.
Type of Construction: I II III N V A B PROJECT COST/VALLTE S
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
i hereby certify that i have fu ished informa[ion on this appiication which is to the best uf my knowledge aue and correct. I alsu certify that I am the owncr or author�zed agrnt for thc
atwve-mcnaoned prope that all cunstruction will conform to ail existing state and local laws and will proceed in accurdance with submittcd plans. ! am aware that the buildmg
I ufficiai can revoke th rmit for just ca se Furthermore, I hereby agree that the city officia! or a designee may enter upon the propecty to perform needed mspections.
` x ' (�.c. �3 `� � 33 9 Il /'a1
Signature Contractor's License No. ate
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 $ 9 7�
This Applicallon Becomes Yout Building Perntit When Approved Paid 7� Recei t N
Date : ' B �
Buildina Utlicinl D�te
This �s to certify that the request in the above applicahon and accumpanying documents is in accordance with the City Zoning Chdinancr and may protted u requcsted. This ducument
when signed by the Ciry Planner constitutes a tempurary Certi6care of Zonmg compliance and alluws construction tu commence. Before occupancy, a Cc�ruficue nf Occupancy must be
issucd.
Planning Director Date Special Condidons, if any
24 hour notice for aii inspecteons (9S2} 447-9850, fax (952) 447-4245
4646 Dakota Sdreet Prior Lake, MN 55372