HomeMy WebLinkAboutBuilding Permit #13-1094 ;r� )
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DATE TIME
CITY OF PRIOR LAKE
1NSPECTION NOTICE SCHEDLlLED � �j _
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ADDRESS �����J 5 �Q���-t....
OWNER CONTR.
PHONE NO. PERMIT NO. �?/" f�� ��
❑ FOOTING 0 P�UMBING RI CI FJUGRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMtNG ❑ WATER HOOKUP ❑ FIREPLACE RI
O INSULATION O SEVYER HOOKUP 0 FIREPUICE FINAL
D FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION � ECH FINAI. ❑
COMMENTS: - �
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�WORK SATISFACTORY, PROCEED
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❑ CORRECT AC7lON AND PROCEED
❑ CORRECT WO OR REI ECTION BEFORE COVERlNG
Inspector: � OwnedContr:
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f CA,k�44 50 FOR THE NEXT INSPECTION 24 NOURS IN ADVANCE.
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CODE REQUIREMENTSARE FOR YOUR PERSONAL H�4LTH �f SAFETY.�
[HSNOTI
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� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ( �
" `� AND UTILITY CONNECTION PERMIT U ` Z ' �
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r �'NES��
� �� ��� � ,. �„�e File PERMIT NO. �
2. Pink City
3. Yellow Applican[ � /
lease e or rint and si n at bottom
ADDRESS ZONING (ot�'ice use)
I� 22� S� r�e.. l� N�
LEGAL DESCRIPTION (ot�'ice use only)
LOT BLOCK ADDITION PID Z S- Z/ � O�. U
OWNER I ,,s' �
(Name) �Q�V � � _ ��(N�. C 7(� S (Phone) � � 2' ��J� ' � � 2 2
(Address) � 2`L�j S�I,�Y � N �
BUII,DER L _ ` r 2
(Company Name) /� � `Il�'� �i`p✓L o �M �� ne) � lOJ � ' ��Ja �
(Contact Name) (Z.t7��-� w' (Phone)
(Address) �1 C� �'� ���� n/�, Cj�2"t
TYPE OF WORK ❑ New Construcrion ❑Deck ❑Porch �te-Roofmg ❑Re-Siding �Lower Level Finish ❑ Fireplace C
❑Addirion ❑Alteration ❑Utility Connecaon
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc: �� � �1 �/�
Type of Conshuction: I II III N V A B n
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $"l� �'��
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished inforniation on this application which is to the best of my knowledge true and correM. I also certify that I am the owner or authorized agent for the
above-mendoned property and that all construction will conforcn to all existing state and local laws and will proceed in accordance with submitted plans. I am awaze that the building
official revoke 's pernut for just e. Furthermore, I hereby agee that the city official or a designee may enter upon the pmperty to perform needed inspections.
X � �lS/ J l lo��
Signature Contractor's License No. e
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 Pernut Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid Re ei t NO.
Date / , B
Buildin Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance a d may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows consrtuction to commrnce. Before occupancy, a CertiScate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspecHons (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prlor Lake, Minnesota 55372