HomeMy WebLinkAboutBuilding Permit #12-211 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED ����Q�/�
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OWNER CONTR.
PHONE NO. PERMIT NO. �� — p `Z,��
❑ FOOTING O PLUMBING RI ❑ FJ(/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ ITE INSPECTION ❑ MECH FINAL ❑
_COMMENTS: b� �
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45� �
�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑�aRREC RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector OwneNContr:
CA L 7 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
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o F pR�O, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
.� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � ' �� ,' �
� � AND UTILITY CONNECTION PERMIT
'�'"NES°�`' 1 Whrce File pERMIT NO.
2 Pinl. City � ^� ' �1 �'
� Yellow Applicani L L �
Please e or rint and si at bottom)
� ADDRESS ZOI�TING co�;�� �st>
`-�� -1 '� �r �� V i� �-w �"" 5 � �:"�� -
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LEGAL DESCRIPTION (of1'ice use only)
LOT BLOCK ADDITION PID
� OWNER -, ,
(Name) _ ( i k.-• �,t.(... � `� �AC'C�, (Phone) � � L — � � � — �� ��{
(Address)
BUII,DER
� (Company Name)
(Phone)
(Contact Name)
(Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck Porch ❑Re•Roofing ❑Re-Sidmg ❑Lower Level Fmish ❑ Fireplace
❑Add�hon ❑Alteration ❑U l�ry Connection
CODE: �^ R.C. ❑I.B.C. ❑ M,sc
Type of Construction: I II III N V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALLTE $
Division: 1 2 3 4 5 (excluding land)
I hereby ceruty that 1 have hirmshed mformauon on this appLcauon which �s tu the brst of my knowledge hue and correct I alsu ccihfy that I am the owne� o� authorized agent for the
above-menuoned property and that all conshuction wdl conform to all existmg state and local laws and w�Il proceed m acco�dance w�th tiubmrtted plans I am aware that the bmldmg
I nffic�al can revoke th�s pe�m�t for�ust cause Furthermare, I hereby agree that the city official or a designee may enter upon the p�operry to perform necded mspecuuns
X - � v`-.i L....— � �13�-'Q.x-C.��
Signature Contracror's License No.
Date
Permit Valuation � O � r � Park Support Fee # $
Permit Fee $ � SAC # $
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Plan Check Fee $ �.� Water Meter Size 5/8", 1", $
State Surcharge $ -Z ��v Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # g
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permrt Fee $ TOTAL DUE � , � g
� �3 . 2. �.
This A cation omes our Bpilding Permit en Ap oved Paid
i t No.
3 � � 2 Date d,/ Z-
Bui dint - ..d Date
This �s [o ify that th e est m the abuve apphcat�on and accompanymg docu ents �s acco�dance wuh the Gry Zonmg Ordmanee and may proceeA ati requcsted Th�s ducument
when si by e Gt P ne� � ututes a rempFlrary Ceitificate of Zonmg co phance nd allows cunstructwn to commence Befuie uccupancy, a Ccit�ficate �>f Occupancy must be
�ssucd
3 z f Z-
Plannm at Spec�al Condrtions, if any
24 hour noticc for all inspections (952) d47-9850, fax (952) 447-J24S
4646 Dakota Street Prior Lake, MN 55372
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DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS �4- �,,�,� v � � °
TYPE OF WORK
USE OF BUILDING
PERMIT NO. � Z- �"7�'r DATE ISSU D Z (z
BUILDER G v � PHONE -
NOTE: THIS.IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECT R DATE
Foo�NC� t�e��� � s�-r�r� �sc � �
PLACE NO CONCRETE UNTIL ABOVE NAS EEN SIGNED
FRAMING
FINAL � �
FOR ALL INSPECTIONS (952) 447-9850
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