HomeMy WebLinkAboutBuilding Permit #12-0955 �/
pATE TIME
CITY OF PRIOR LAKE gCHEDULE� �`� �"��
INSPECTION NOT10E ---
ADDRESS �� Z `�� � ��r�c� � � � � .;'' i.l��
OWNER CONTR.
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PHONE NO. PERMIT NO. ( �` � � � �
O FOOTING � Pi.UMBiNG Rt 0 EX/GRAD/FILLING
t] FOUNDATION
❑ MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP ❑ FIREPLACE RI
p INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL O PLUMBING FINAL ❑ G�AS�L�IN��E� TST
O SI7E INSPECTION O MECH FINAL �,,,�--�= -�.s--
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COMMENTS:
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❑ WaRK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CA�L FOR REINSPECTION BEFORE COVERING
Inspector: Owner(Contr:
CALI. 447-9850 FOR THE NEXT INSPECTION 24 NOURS 1N ADVANCE.
CODE REQUIREMENTSARE POR YOUR PBRSONAL HEALTH dc SAFETY!
INSNOTI
o 4 pRIO� CITY OF PRIOR LAKE BUILDING PERMIT, � Date Rec'd
ti TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
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� AND UTILITY CONNECTION PERMIT �• �� �'
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� �. wb�� File pERMIT NO. C''
2. Pink City r�� � �'�]
. . . 3. Yellow Applicant �/
ease or rint and si at bottom
ADDRESS ZONING (ott'ice use)
,��j� piww b��t. w/eoa �f. I�f� 1��;06 �AF�t,, 1�1� 'S$,�ZL
LEGAL DESCRIPTION joffice use only)
LOT BLOCK ADDITION PID
OWNER � � � si I {.S (Phone) ° �sZ' `f�'f�- �c�
(Name) _� v� '
(Address) 3� �' mb��✓�� �; I�(� ���oC' �tike . �!� rj�5 71�
(Company G�'1 � �� i (Phone) �SZ'���� ���
(Contact Name) �ro �� �s`L - �R = uA4�
(Address) Q i � I��f�SV ��� 1 N S� �
TYPE OF WORg ❑ New Construction ❑Deck OPorch Re-Roofing Re-Siding �Lower Level Finish ❑ Fireplace
�Addition ❑Alteration DUtility Connection
CODE: ❑I.R.C., ❑I.B.C. ❑ Misc.
Type of Constraction: I II III IV V A B /,' S 7. ,�
Occnpancy Group: A B E F H I M R S U PROJECT COST/VALUE S n -
Division: 1 2 3 4 5 (eacluding land)
I hereby certify that I have furnished information on this application which is to the best o£ my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-meationed property and t all conshuction will conform to all exisding state and local laws and will proceed in accordance with submitted plans: I am aware that We building
official c evoke this 't f�ust cause. Furthemiore, I hereby agrce that the city offiq or a des' may rnter upon the property to perform needed inspecti .
X t��7��a Q' ,�1 f �t
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surchazge $ Pressure Reducer $
p� $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Pemut Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ ��� $
Gas Fireplace Permit Fee $ TOTAL DiTE $'
This Application Becomes Your Building Pernut When Approved p�d � Cei t NO.
Date B
Buildin Official Date
This is to certify that the request in the above applicadon and accompanying documents is in acwrdance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planna constitutes a temporary Certificate of Zoning compliance and allows rnnstruction to commettce. Before occupancy, a Certificate of Occupancy must be
issued.
p�anning Dire�tor Date Special Conditions, if any
24 hournotice for aR inspecHons {952) 447-9850, faa (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Mfnnesota 55372