HomeMy WebLinkAboutBuilding Permit #13-1121 DATE TIAAE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED � �
ADDRESS ��'f 7� �p��^s f� rn S �
OWNER CONTR.
PHONE NO. PERMIT NO. `� � �� Z�
O FOOTING 0 PLUMBING RI ❑ EXIGRAD/FILLING
❑ FOUNDATION ❑ MECH RI O COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION .�;� ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
'�#INAL �� O PLUMBING FINAL ❑ GASLINE AIR TST
O SITE INSPECTION 0 MECH FINAL �
COMMENTS:
��M1IORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector ` , Z,�_ OwnedContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYl
ixsxor,
o � rR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�, �. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT '��/��
+'�, t. Whi�e F,�� PERMIT NO.
� 2. Pink Cily l� �' f��
3 Yellow Applicant � (
Please or 'm and si at bottom
ADDRESS ZOI�TING (oa'ice usey
3� � ( .e���.� n r ��
LEGAL DESCRIPTION (ott'ice use only)
LOT BLOCK ADDITION PID --� ��� "� ���
OWNER ,/
(Name) �� ► ��" �� /� (Phone)
(Address) �� � '�, � j
BUII,DER
(Company Nam� � � � `�`^�`� (Phone) ����"'1 _.��'�'? �_
(Contact Name) (Phone)
(Address) � \��{�„ \ \ a Z
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Firepiace
❑Addidon �Alteration ❑Uality Connection
CODE: ❑I.R.C. �I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B
PROJECT COST/VALUE S{ G1 Df�
Occupancy Group: A B E F H I M R S U (excluding land) �
Division: 1 2 3 4 5
i hcrrby certify that i have fumished information un this app(ication which is to the best of my kaowicdge tnie and correct. ! aiso cerdfy that I am the owner �n authorucd agent for the
above-ment�oned property and that atI cunst n will confurm to all existing state and local laws and wiil proceed in accordancr with submitted plans. i am awue that the buildmg
otl'iciai can rev e thu per for just cause. hermore, I hereby agree that the ciry officia! or a des[gnee may enter upon the propetty to perform necdcd tnspections.
x � �o��''�� 1L7�"� / 13
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 $
.
Titis AQptication Becomes Your Building Perntit When Ap ed Paid ReCei t NO. D
Date B
Buildin � Otticial pme
Th�s is to certify that thc requcst in the above applicat�on and aceompanying documents is in accordance with the City Z.�ming Ordinance and may pruceeA as requc�sted. 7'his dncument
when signed by the Ciry Planner cunsntutes a tempurary Certificate uf Zoniag compiiance and allows canstruction ta commence. Before �xcupancy, a Cc7hticate ��f Occupancy must bc
issucd.
Planning DirecWr Date Sp�ia! Condidons, if any
24 hour noticc for aii inspections (452) 447-985(1, fax (452) 447-4245
4646 Dakota Street Prior Lake, MN 55372