HomeMy WebLinkAboutBuilding Permit #12-1063 �/
DATE TIME
CiTY OF PRIOR LAKE
INSPECTION NOTICE SCHEDUI.ED ^ - � ° � �
ADDRESS 1 �� � � C.� � �:. -� L.. ��i"'v':. �}—� 1...
OWNER CONTR.
PHONE NO. PERMIT NO. ���(, i± L< �
O FOOTING 0 PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI � COMPlA1NT
❑ FRAM(NG ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPI.ACE FiNAL
0 FINAL ❑ PLUMSING FINAL � GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI. �' r+��, �e ;`� ��.�'
!.-�. fi_' s ... ., . �i i....
COMMENTS:
� � • .
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 44T-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & S�iFETY!
INSNOTI
r
o � QR� CITY OF PRIOR LAKE BUIL•DING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �/� /,�
� x AND UTILITY CONNECTION PERMIT
U �rj
y P 1. White Fiie
��vN�so� z �;�► �,� PERMIT NO. /Z� �Q��
3 Yellow Applicam
Please or rint and si at bottom
ADDRESS ZOIVING (ofeice use)
l � �r 1'--� L�� —�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER v
(Name) /�e�P��U s � 'l� � �—� (Phone) 9 s� —
(Address)
BUII.,DER
(CompanyName) �t oti �' �`� (Phone) 9S
(Contact Name) � � (Phone)
(Address) — j � K'e. U �n � "s"'z� ` m �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch �Re-Roofing �Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Udliry Connection
CODE: ❑I.R.C. �I.B.C. � Misc.
Type of Construction: I II III IV V A B pROJECT COST/VALLIE S xi ��
Occupancy Groap: A B E F H I M R S U (excluding land)
Division: 1 Z 3 4 5
I hereby certify that i have fumished information on this application which is to the best of my know►cdge mue and correct. 1 aiso certi(y thac [ am the owncr or authunzed agrnt for the
above-menCioned properry and that all construction wili conform ro ail existing state and local laws and will proceed in accordance wich submitted plans. I am aware that the buiiding
ut1'icial revoke this permit for jusc cause Furthermore, I hereby agree that the c!ry official or a designee may enter upon the property to perform necded iacpretiuns.
X ��.�.�c�_ —- r3 �/� �fs/s'� 6 I- � 5�—� 2..�
� Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Perrnit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer �
Penaity $ Sewer/Water Cannection Fee # $ G
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DI7E $
This Apptication Becomes Your Building Pernut When Approved Paid • ei t No.
Date / _
Buildin � Ut�icial Date
This u tu certify that thc requcst in the abuve applicahon and accumpanying documents is in accordance with the City Za>ning Ordinance and may proceed as rcqucsted. 7'his document
when signrd by the City Planner const�tutes a tempurary Certificate of Zoning compliance and aUows consrructinn tu commence. Before occupancy, a Ceruficuc of Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour notice for ail inspections (952) 447-985(1, fax (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372