HomeMy WebLinkAboutBuilding Permit #13-1108 ��f
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULEO (O !6 (
ADDRESS I�I I�� �Ufi�4 � n �� I.�.G�; rC.Q �-�
OWNER ��,CONTR.
PHONE NO. PERMIT NO. �� — �� O��
O FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI 0 COMPtAINT
O FRAMtNG ❑ WATER HOOKUP ❑ FIREPLACE Rt
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
t¢1''FINAL ❑ PLUMBING FtNAL � GASLlNE AIR TST
❑ SITE INSPECTION O MECH FINAL ❑
COMMENTS: �
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ COR CT WORK, CALL FOR REINSPECTION BEFORE COVERING
inspector. Owner/Contr.
CALL 447 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SriFETY.�
rNSnori
o� rKI ��P CITY OF PRIOR LAKE BUILDING PERMIT, C.�� Date Rec'd
ti � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE J
� AND UTILITY CONNECTION PERMIT � •�� /�
� �,�'
NNES�
1. White File pERMIT NO .
2. Pink City .' �) �
3. Yellow Applicant ��'
(Please e or rint and si at bottom
AD ZONING (ot�'ice use)
I`�'l5 mmi G � �
LEGAL DESCRIPTION (oflFice use only)
LOTf ,� BLOCK Z ADDITION iq- �C� �-r �C ��� PID o�j�-,� �`� d�S �'
(Na � �i I�� N 1 � �/� (Phone) �� � � � � — ( � Y! �
(Address)
BUII,DER ��� n(, � ( (� �� �
(CompanyName) ,�N����''�1��/��V� (Phone) �_�,
, (Contact Name) ���-�/ �C'fN.S (Phone) ����� �0�
(Address) ��j � � '�J
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connecti n
CODE: �I.R.C. ❑I.B.C. ❑ Misc:
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 $ �• ��
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fiirnished information on this application which is to the best of my lmowledge hve and correct. I also certify that I am the owner or authorized agent far the
above-me 'oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c revoke this p 't for ju t cause. Furthermore, I hereby agee that the city of�icial or a designee may enter upon the properry to perform needed inspections
X BG(o�t�(ot ��a 13
Signature Contractor's License No. Dat
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 $
T' pplication Becomes Your Buiiding Permit When Approved Paid ReCei t NO.
� /� Date B
Buildin Official Da1fe� .
This is to certify that the request in the above applicaaon and accompanying documenis is in accordance with the Ciry Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9&50, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372