HomeMy WebLinkAboutPlumbing Permit #14-166 C�TY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED Z �
ADDRESS J� � �_
OWNER CONTR.
PHONE NO. PERMIT NO. _� L•� � I(� C�
0 FOOTING _ � ���
❑ FOUNDATION � PLUMBING RI ❑ E)(/G�LING
O FRAMING � MECH RI ❑ COMPLAIN
❑ INSULATION � WATER HOOKUP ❑ FIREPLACE RI
0 FINAL � S�R HOOKUP ❑ FIREPLACE FINAL
O SITE INSPECTION � PLUMBING FINAL � GASLJNE AI�T�j
❑ MECH FINAL ��` (,J�1, o �,�,����_
COMMENTS:
0
� WORK SATISFACTORY, PROCEED
❑ ORRECT ACTION AND PROCEED
❑ CORR T RK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto :
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY.�
lNSNOTf
oF pR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� x AND UTILITY CONNECTION PERMIT
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��'NESO� �� r 2 �, ; �� c; PERMIT NO . —''��
; Yellow Applicam
Please or rint and si at bottom
ADDRESS ZONING (o� use>
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LEGAL DESCRIPTION (office use only)
LUT BLOCK ADDITION PID (�'S ���� G�;j � Q
OWNER I � � `���
(Name) �i./ ���L� �'" -- (Phone)
(Address)
BUII.,DER �
(Company Name)��.���� ���� (Phone) �Q��OU����
(Contact Name) �__�_o:,__�� (Phone) (�/ a- �� � �� ��
(Address) '1i � h •
TYPE OF WORK ew Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alterarion ❑Udtity Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Consm�ction: I II III IV V A S pROJECT COST/VALITE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
i h��reby certify that 1 have (iirnished information on this apptication which is ro the best uf my knowicdge true and correcc. I�Iso certify that I am the owner or authnr�zcd agent fur thc
aiwve•mennoned propeKty and that ail construction will conform to all existing state and local taws and will proceed in accurdance with submittcd ptans. I am aware that the buildmg
ufficial e this rmrt for just cause Fmthermore, I hereby agree that the city official or a designee may enrer upon the property to pnform necdcd mspcctions.
X 8C� U�^�� �/ G fa �l � 19_� �� ��, lo y
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 $ 6y„�
Tluis Application Becomes Your Building Pern�it Whrn Approved Paid ./ Recei t NO.
Date � " .50 B
Buiidin�� UtTcial Date
7'his is to certify that the request in the above application and accompanying documents is in accordance with the Ciry ZAming Ordinantt and may proceed as requcsted. This ducument
when signed by the City Planner constitutes a temporary Certificate uf Zonmg compliance and altuws construction tu commence. Befure �xcupancy, a Ce�t�ficate uf Occupancy must be
issucd.
Planning Director Date Special Condi6ons, if any
ZQ hour noticc for all inspectioas (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Sh�eet Prior Lake, MN 55372