HomeMy WebLinkAboutBuilding Permit #09-0744 CfiY OF PRlOR LAKE � DATE �
lNSPECTION NOTlCE
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ADDRESS ( � �_ �s� � � / , �
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OWNER
CONTR.
PHONE NO. PERMIT NO.
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D FOOTING ❑ PLUMBING RI
❑ FOUNDATION t� EX/GRAD/FILLING
O FRqMING � MECH R1 ❑ COMPI}IINT
❑ INSULAT�pN � wATER HOOKUP
� SEWER HOOKUP � F�REPLqCE RI
[7 FINAL O PLUM8ING FINAL � F�REPLACE FINAL
❑ SITE INSPECTION O GASLINE AIR TST
❑ MECH FINA� �, A �, f � ,,�
COMMENTS: �
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� WORK SATISFACTORY, PROCEED
O CORRECT ACTION AND PROCEED
O CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr.
CALL 447_gg50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENT�',q� FOR YOUR PERSp1yA� g�TH & Sr1FETY.�
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oF rrt� CITY OF PRIOR LAKE BUILDING PERMIT, � Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE g �� G c
AND UTILITY CONNECTION PERMIT �
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M��'NES��P I. White File
2. Pink ��� PERMIT NO. a �c 0 7
3 Yellow Applicant
Please e or rint and si n at bottom)
ADDRES$ ZOI�TING (ott'ice use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER r
(Name) �C� �1 �Gc � `�'� L- S (Phone) '
(Address) C � � f �j �_ c� � � ���(
BIJILDER
(Company Name) � � � G� C l_�- C_ (Phone) � sr� a�G ���a
(Contact Name) f � ��-(' (Phone)
(Address) ``2 "� �- �1 cr1 i< (� � ' _V,
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re-Roofing Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Conn tio
CODE: ❑I.R.C. ❑I.B.C. ` ❑ Mis .
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALiTE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have firrnished information on this application which is to the best of my knowledge true and correct. I also cettify that I am the owner or authonud agent for the
above-mentioned property and that all consn�uction wilt conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can re ke this permit for jus Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform necded inspections.
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Si e Contractor's License Na 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 DLTE $
This Application Becomes Yoar Building Permit When Approved Paid '�— ei t NO.
Date �d B
Buildin � Ofticial Date
This �s to certify that the request in the above appiication and accompanying documents is in accardance with the Ciry Zoning Ordinance and may proceed ac requcsted. This document
when signed by the Ciry Planner constitutes a temporary Certificate of Zoning compliance and allows construction ro commence. Befure occupancy, a Certificate of Occupancy must be
issued.
Planning D'uector Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372