HomeMy WebLinkAboutBuilding Permit #13-0420 �
OATE TIME
CITY OF PRIOR LAKE
INSPECTtON NOTICE SCHEDULED �� �
ADDRESS �'� �.-�- ��,
i
OWNER CONTR. � �
PHONE NO. PERMIT NO. � �2
0 FOOTING � PLUMBING RI ❑ EXlGRAD/FILLING
� FOUHDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
0 INSULA710N O SEVYER HOOKUP Cl FIREPLACE FINAL
O FINAL ❑ PI.UMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION O MECH FINA� ❑
COMMENTS:
� �, �
� WQRK SATISFA TORY, PROCEED
❑ CORRECT ACTiON AND PR�CEED
❑ CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Inspect : OwnedContr.
GA - 8 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH � SfiFETY.�
lNSHOTt
oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, � Date Rec'd
a, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /
= � AND UTILITY CONNECTION PERMIT (� �3
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��'VNES�� �. "'h;�e `;�° PERMIT NO. �3',_��/�
2 Pink Ciry
3 Yeilow Applicant ��
Please or rint and si at bottom
ADDRESS ZONING (otFice use>
i S 2 ��� �l ���--� �c;� �. �-_ � 1 �
LEGAL DESCRIPTION (oflEice use only) � �/��
/ �t'' l`�
LOT�(pBLOCK ADDITION �I/� V� ��,��jj/ PID J� "D,� J���
OWNER � j �, ^ n �
(Name) �r�[�1,v1 �t�l V 11C� (Phone) �l Z~ rt0� '��g�
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(Addxess) � sZ °j �`�- f ��
BUII,DER �� �
(Company Name) ��f�� (Phone) ��' Z� � � �� l
(Contact Name} p ' �--- (Phone)
(Address) �5 ,� y� �� � � �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roo&ng ❑Re•Siding ❑Lower Level Finish ❑ Fireplace
❑Addition �Alteration ❑Utility Connection
CODE: ❑I.R.C. []I.B.C. O Misc.
Type of Construction: I Ii III IV V A B pROJECT COSTNALUE $��C� �
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that [ have fumished information on this apptication which is ro the best of my knowledge true and correcc I also certify that 1 am the owner or wthonud agcnt for the
above-mennoned proprrty and that all construction will conform ro all existing state and tocal laws and will proceed in accordance with submitted plans. I am aware that the buildmg
utFicia! can revoke thi, permit for jusc cause. Furthermore, I hereby agree that the ciry officiai or a designee may enter upon the property to perform necded mspections.
� �C / �T �o ���— _ s� c�/ /S'�i �.
Signature Contractor's License No. Date
Permit Valuation ��Z j(� (J � Park Support Fee # $
:
Permit Fee $ .T �' SAC # $
�
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ �� v Pressure Reducer $
Penalty $ Sewer/Water Cannection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ �
This Appticarion Becomes You Building Permit Wheu ptoved pa ReCei t NO.
� Dat � $
�
uild r: Utii al Date
Th�s u to certlfy that the requcst in the abuve applicauon and accumpanying dexuments u in accordance with the City Zonin�; Ordinance and may proceed ae requcsted. This ducument
when signed by the City Planner consututes a tempurary Certificate uf Zoning compliance and alluws consrruction to commence. Befarr cKCUpancy, a Ccvhticate ��f Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (9g2) d47-985(i, fAx (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
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