HomeMy WebLinkAboutBuilding Permit #14-155 DATE TII�AE
CITY OF PRIOR LAKE SCHEDULED
INSPECTION NOTICE —�'
ADDRESS �� � �n il1 D�,J' la.�.�/�'
OWNER CON7R.
PHONE NO.
PERMIT NO. � – S J
O PLUMBING RI ❑ EX/GRADIFILLING
❑ FOOTING p MECH RI ❑ COMPI-A�NT
❑ FOUNDATION p FIREPLACE RI
❑ FRAMING ❑ WATER HOOKUP
❑ SEYVER HOOKUP ❑ FIREPLACE FINAL
❑ INSULATION � pLUMBING FINAL ❑ GASLINE AIR TST
� INAL ❑
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
�ORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORR T K, 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 & SAFETY!
INSNOT)
oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � ZS ��
� � AND UTILITY CONNECTION PERMIT �
U �
~�NNES��� i. wn��e File PERMIT NO . /'�� I��
� ?. Pink City
; Yeliow Appiicam L
Pleasc or rint and si at bottom
ADDRESS ZONING (ut�'ice use�
��-' � Gt � �"� r - 1� �,
LEGAL DESCRIPTION (of1�'ice use only)
LOT BLOCK ADDITION PID
OWNER � —
(Name) (Phone) ��—��� — � /�
(Address) " $ � �"�
BUII,DER ., Cl� �Q Q� (y � l nQ�
(Company Name) j— (Phone) FJ O J b UlU
(Contact Name) .� (Phone)
(Address) � 'Q � � �1 �a ��
TYPE OF WORK ❑ New Construction ❑Deck ❑Po e-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireptace
❑Addition ❑Alteration ❑Utility Connectio
CODE: ❑I.R.C. ❑I.B.C. O Misc.
Type of Construction: I II III IV V A B pROJECT COST/VALLTE S��1 �6
Occupancy Group: A B E F H I M R S U (exciuding land)
Division: 1 2 3 4 5
i hcreby certiCy that i havr fumished mformation on i is apptication which is ta the best of my knuwiedge true and correct. I atso cenify thac t am the owner or authonzcd agent for thc
aiwve-mennoned pro and that ail construction 11 conform to aU existing state and loca! taws and will proceed in accordance with submittcd plans. i am aware that the buiiding
ufficial can revoke thi lt for just cause Furthe ore, I hereby agree thac the ary official or a designee may enter upon the property to prrform necded mspcctiuns.
X - ��,. �?� r�_ -� --
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size S/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 S
Gas Fireplace Permit Fee $ TOTAL DiTE $
Tiuis Application Becomes Your Building Pem�it When Approved Paid R i t No.
Date � B
Buildine Ot�icial D�te
This is to certify that the requcst in [he above appticahnn and accompanying documents is in accordance with the City Zoning Ordinance and may yroceed u requcsted. l`his ducument
when signed by the Ciry Planner cc�nstrtutes a tempurary Certifrcare of Zoning comp(iance and allaws construction to commence. Befure �xcupancy, a Ceruficate uf Occupancy must be
issucd.
Planning Director Date Special Condidons, if any
24 hour noticc for ali inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372