HomeMy WebLinkAboutBuilding Permit #11-1021 �/
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NCITICE SCHEDULED L% ° 1 G -1<;
'� � � l'�. f ` :: a a � � P'� c',�° !' -r.
ADDRES5 �` t.
OWNER CONTR.
PHONE NO. PERMIT NO. � � ~ �� ,� �
O FOOTING O PLUMBING RI ❑ E7UGRAD/FILLING
❑ FOUNDATION 0 MECH RI ❑ COMPLAINT
O FRAM(NG ❑ WATER HOOKUP � FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
[a FINAL Cl PLUMBING FiNAL � GASLINE AIR TST
0 SITE INSPECTION 0 MECH FINAI ,P'�� �� �' ��.'-
� , �i
COMMENTS: � '
!..
❑ WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROGEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
inspector. . � OwnerlContr:
CAIL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
�
�� pRj ��f' CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�� D� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE `0 � j/
L' AND UTILITY CONNECTION PERMIT �
d ,`F�
�'NBS�
1. White File pERMIT NO. !� �� �,
2. Pink Ciry
3. Yellow Applicant
ease or 'nt and si at bottom
ADDRESS J r �t, -s, C y � 0 5 St� ��v��n S�'�'-� t-+' s� ZONING (ott'ice use)
�r : o f �u�, �t S 5�? a—
LEGAL DESCRIPTION (ofl�'ice use only)
LOT BLOCK ADDITION PID
OWNER (� -
(Name) 1..�`�!' � � i °� b � (Phone) (o t a- ^ � � ^` O ? r J 2-
(Address) S�S S�j Gro ss �,�., d,�r.,� S�-�-.�, � SE �r; r- l,. M N S S 3�7 a-
BUII.,DER
(Company Name) ��'�'��t'S '� ��tS LLL (Phone) ° �S a 3 y5 - 3`i o$
(Contact Name) �o r...� IJ q.r..ti t. �.. (Phone)
(Address) ti a'-�SS \ ¢ 1�.0 � �5 � o•.,.. cl �� S. Sa..i .� N 5 5 3'7 $"
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing e-Siding ❑Lower Level Finish ❑ Fireplace
�Addition �Alteration ❑Utility Connection
CODE: �I.R.C. ❑I.B.C. �Misc: oZ �o $!l • ��7 S k S 1 dM,.��
Type of Construction: I II III IV V A B �
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ �. S�/TD —
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and coned. I also certify that I am the owner or authorized agent for the
above•mentioned properry and thaz all construcHon will rnnform to all existing state and local laws and will proceed in accordance with submitted pians. I am aware that the building
official can revoke this permit for just cause. Furthermore, I hereby agee that the city official or a designee may enter upon the property to perform needed inspections.
X aa(o 3? u� a- / o ,
Signature Contractor's License No. ate
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 $ �J
This Application Bernmes Your Building Permit When Approved Paid - Recei O. Ll
Date 6 , B
Buildin Official Date
This is to certify that the request in the above applicallon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner rnnstitutes a temporary Certificace of Zoning compliance and allows rnnsduction to mmmrnce. Before occupancy, a CertiBcate of Occupancy must be
issued.
Planning Director Date Special Conditions, if azry
24 hour aotice for all iaspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 35372