HomeMy WebLinkAboutBuilding Permit #14-240 CITY OF PRIOR LAKE DATE TIAAE
INSPECTION NOTICE SCHEDULED �
ADDRESS _ � y s5 O- �• �o ,�
OWNER CONTR.
PHONE NO. PERMIT NO. _� c/ _�Yd
� FOOTING O PLUMBING RI ❑ FJ(/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI D COMPLAINT
O FRAMING 0 WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP O FIREPLACE FINAL
O FINAL ❑ PLUMBING FINAL O GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: Re�ooF
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
❑ CORRE , CALL FOR REINSPECTION BEFORE COVERING
Insped r. OwneNContr:
CA 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETYl
rnsnor,
oF rR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMpORARY CERTIFICATE OF ZONING COMPLIANCE �` � ��
� � AND UTILITY CONNECTI�N PERMIT
�'��Neso�" �. wm�� F��e PERMIT NO . � �- --_'�
2 Pink City Z
3 Yellow Applitam �
Piease or rint and si at bottom
ADDRESS , ZOIVING (o�'ice use>
i `� � � Z 1 �, � �- �. �� �J �.
LEGAL DESCRIPTION (ot�'ice use only)
LOT BLOCK ADDITION PID
OWNER �/� , f
(Name) r ` � � 't . l� � f` <- n �-�— (Phone)
(Address)
BUII,DER q
(Company Name)t , d � (Phone) I S �" ��; ,��
(Contact Name) � �� (Phone) �
(Address) � � z � 7 {,
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TYPE OF WORK ❑ New Construction Deck ❑Porch �e-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition �Alteration ❑Utility Conne ion
CODE: ❑I.R.C. ❑I.B.C. O Misc.
Type of Construction: I II III IV V A B
PROJECT COST/VALUE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 Z 3 4 S
1 hereby certify that I have fumished mformation on this ap tcatio which is to the best of my knowlcdge true and cottect. [ also cectify that 1 am the owner or authorized agent fur the
above-mentioned roper[y and tha[ all co tn�ction wiil nfur o atl existing state and local taws and wip proceed in aceordancr with submltted pians. I am awarr that the buildmg
utTicial can r his per or� e Furthermo , I he y agree that the c�ry official or a designee may enter upon the property to pc��form necded mspections-
x � -� � �� .2� � �-- �1 �-,,��
Signamre Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/$"; I"; $
State Surcharge $ Pressure Reducer $
Penaity $ Sewer/Water Connection Fee # $
Piumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTA.L DUE
This Appiication Becomes Your Building Perntit When Approved Paid ' Recei NO.
Date . l . B
Buildina Utticial Date
This u tu certify that thc requcst in thr abuve appiicauon and accumpanying documents is in accordance with the Ciry Zoning Ordinance and mYy proceeA as requcsted. This document
when signed by the City Planner consn�utes a temporary Certificaee of Zoning compliance and allows construccion to commence. Before cucupancy, a Ceruticate of Occupancy must be
iuucd
Pianning Director Date Special Conditions, if any
24 hour notice for a►1 inspections (9S2) A47-9850, fax (952) 447-�245
464b Dakota Street Prior Lake, MN 55372