HomeMy WebLinkAboutBuilding Permit #13-0630 � ��' DATE TIME
CITY OF PRIOR LAKE
INSPECT[ON NOTICE SCHEDULED �� �
ADDRESS �
OWNER CONTR.
PHONE NO. PERMIT NO. �-��� ,a ��
0 F0071NG 0 PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WA7ER HOOKUP � FIREPLACE Rt
❑ INSULATION � SEWER HOOKl7P ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMSING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION � MECH FINAI. �
COMMENTS• % � cn
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� ORK SATISFACTORY, PROCEED
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❑ CORRECT AC710N AND PROCEED
O CORRECT WOR FOR ECTION BEFpRE COVERING
Inspector: OwnedContr:
C 44 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE QUIREMENTSARE FOR YOUR PERSONAL HEALTH 6c SAFETY.�
lNSNOTI
0� PRIp�
�� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� D� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" AND UTILITY CONNECTION PERMIT
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1. White File pERMIT NO . / r �
2. Pink City ? � " /_�//
3. Yellow Applicant ..J r� v
lease e or rint and si at bottom
ADDRESS ZONING (oflEice use)
�q 3 P , e. � Q� � �� �
LEGAL DESCRIPTION (ofTice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
BUII,DER � � n
(Company Name) (Phone) "� c5�� - 5aa �
(Contact Name) ei �r (Phone) � cSa "�` I r U ln �
(Address) � � 1 � � �
TYPE OF WORK ❑ New Construction ODeck ❑Porch ,�Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
�Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. �I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B [y gZ
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ I3� 7OD
Division: 1 2 3 4 5 (excluding land)
I hereby certiEy that I have furnished information on this application wluch is to the best of my lmowledge true and correct. I also certify that I am We owner or authorized agent for the
above-mentioned property and that all wnstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am awaze that the building
official can revoke this permit ar just cause. Furthermore, I hereby agree that the city official or a designee may rnter upon the property to perform needed inspections.
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Signature Contractor's License No. 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 DUE $ ' J !
This Application Becomes Your Building Permit When Approved Paid ReCel O
Date B
Buildin Official Date
This is to certify that the request in the above applicazion and accompanying documents is in accordance with the City 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 Duector Date Special Conditions, if azry
24 hour noHce for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372