HomeMy WebLinkAboutBuilding Permit #14-0094 CITY OF PRIOR LAKE AT TIIiAE
INSPECTION NOTICE SCHEDULED � �
ADDRESS ; `� 1� �� U�` ��'C S
OWNER CONTR.
PHONE NO. PERMIT NO. � --� y�
❑ FOOTING � PLUMBING RI ❑ FJ(/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
� INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
FINAL ❑ PLUMBING FINAL O GASLINE AIR TST
❑ ITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
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?�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. �► �"
OwnedContr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETYl
lNSNOTJ
�� P R I ��P CITY OF PRIOR LAKE BITILDING PERMIT, Date Rec' d
� �� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v �' AND UTILITY CONNECTION PERMIT y y J ����
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` `� F '� PERMIT NO. �¢ P
Z Pink CiIY
3. Ydlow Appl�cant
Please or ' and si at bottom
ADDRESS ZOiN'ING �o� �>
/ 53 � / �� �� c.� �5:,� . ,� �s�
LEGAL DESCRIPTION (o�['ice use only)
LOT BLOCK ADDITION pID � 5. U�J/, 0 a�• 6
OWNER p �.,
(Name) ��?�' � °�E.r.t �M/ �G �5� 7 � (Plione)
(Acidress) S'3 9 / /�� � L cS� � •
Bvu,DER �/Z 81� � �- �
(Company Name) �A"�rt G�31 �n "< �ti-C (Phone)
(Contact Name) �oir� .t3.�d 7 (Phone) l /oL �'b 7 � a"�
(Aadress) 7S i��13v�e. f�•*� S /�ic� -- r�-�.✓ Z
TYPE OF WORg ❑ Nevv Consrracaan �Deck �Poirh L��-� ��-Siding �La�ver Level FinBh ❑ F�eplace
DAddition .�ati� �Ut�ity Con�� 1 �.>
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CODE: (�i:R.C. DI.B.C. ❑ M�
Typc of Cons�uction: I II III IV V A B � D
pccnpancy Group: A B E F H I M g S U PBOJECT COST/VALUE S
�� 1 2 3 4 S �� �)
I hereby oettify thai I 6ave fittnighed infar'mation � ifiis apQliratian whuh is oo d� bc� of my Imawled�e tnu and aoaed. I aLso oatifY that I am the owner � authaized a�eent fbr the
above-mentioned pivpecty a�d that all coosauct�n wiit mnfam to all e�sting stau a� lora! laws and w�l prooced in a000rdaix�e with �ed plaos. I am awaze that the bw7ding
officiai can rewoloe this ' far� ' . FuRhermoce I herebq a@ree d�at the dtY �9a1 or a designee maY �' �� P�S' � P� ��•
X ,�es�3�9� �dry
S�� connactor's License xo. �
Permit Valuation Z � �p — Park Support Fee # $
Permit Fee S Z � Zr SAC # a
Plan Check Fee S Water Meter Size 5/8"; 1"; $
State Surcharge $ �� - Pressure Rednoer S
Penalty $ Sewer/Water Connection Fee # S
Plumbing Pernrit Fee S o Water Tower Fee # S
Mechanical Permit Fee $ , Builcler's Deposit s
' Sewer & Water Permit Fee S 0 �� s
Gas Fireplace Permit Fee S TOTAL D �.Gq,/ ¢— S
� �� petmic ween v Paid ' t No. O
' Date ,, B
r
su�ia� ot���
ord�ane�e aoa may paooeod as mqoe�od. '17vs aocvnmenc
This is to certify the uest m the above applieasinn a� a000mpanying dotau�ts is in wgh ti� Cily 7.onmg a Ce�tificate of Oa,upancy must be
when signed C' o�rtesaumporaxy Cenifirate of ZoninB aad �aa to oommenoe. Before oavpancS,
issued.
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Plannin8 Spoael Caaditim4, if mY
nr notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dekota Street S.E., Prior 1.Ake, Minnesote 553'72
� � pR.,tp� Date Rec'd
� CITY OF PRIOR LAKE PLUMBING PERMIT � � �t�—
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'. B '"` �''` pERMIT NO. �
2. ca�a cn /
3. Yellow nr�i��n
lease or t and ' at bottom
ADDRESS ZONING (oa use)
`.� � °r �P� �� 1�' � �-�
LEGAL DESCRIPTION (office use onty)
LOT BLOCK ADDITIt�N FID
: �� ) ��/L /t � � L� �O � p/^ 7`S (Phone)
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(Address) � �� � �' � �g � �j y�
APPLIC �
(Name) �� � ����r T.� f -P �.c.4� +�� �.�i ur c:e�phone) �f� S� �2 -��,,Z 2
(Address) �� � r u �..� �rl v,e �4 �7 ��r�t��4� S� 3 m 2,
(Address) (City) (Zip Code)
(Conta.ct Person) � d � C G! I' �ir'T `�� (Phone) � (�- .SG .'L � j �
APPLICANT SIGNATURE ' DATE ��1� ��P �
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fi�ture uanti T e of Fiztnre
Bath Tub with or without shower Rou h-ins
Dishwasher ,,� Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laund Tra 1 or 2 com ariment sink Sewa e E'ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-Famity 5149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ 3! O d.�' C� Building Permit #
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STA SURCHARGEFEE $ .SO ��`�'�,��
TOTAL PERMIT FEE $
�orn� u� oo�y�
This Application Becomes Your Bu�lding Permit W6en Approved Paid Receipt No.
Date By
Buildine Ofticial Date
24 hour noNce for all inspections (952) 447-9850, fag (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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