HomeMy WebLinkAboutBuilding Permit #12-0197 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED �/�
t �
ADDRESS � � �
OWNER CONTR.
PHONE NO. PERMIT NO. �� -- � 9?
D FOOTING O PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL
�PLFINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI ❑
COMMENTS:
G �
�S WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: OwnedContr.
CALL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL KEALTH d� SAFETYI
�vsnon
oF PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, t TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �
'�'ip � Wh��e File pERMIT NO.
2 PinA City �+) ,� � �
1 Yellow Apphcam ��
Please e or rint and si at bottom)
ADDRESS ZONING (o�icc use)
��� � ��� ��� � � �
LEGAL DESCRIPTION (oflf'ice use only)
LOT BLOCK ADDITION PID
OWNER G� �) S��(/,
(Name) �� O V � -' �:;�� (Phone) 1 �� � 1 � 7"
(Address) �0
BUII.,DER
(Company Name) (Phone)
(Contact Name) (Phone)
� (Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Sidmg ❑Lower Level F�nish ❑ F�replace
'�Addmon ❑Alterat�on ❑Util�ry Connecaon
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CODE: I.R.C. ❑I.B.C. ❑ M�sc.
Type o Co truction: I II III IV V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certi hat I ave �hed auon on this appLcaaon whuh is ro the best of my knowledge uue and co�rect 1 also ce�ufy that I am the uwnci u� authouzcd agent fur the
above- uo pro eity a d a all co shucn ill conform [o all exisung state and local laws and w�ll proceed m accordance wrth e��bm�tted plans 1 am awa�e that the bmldmg
utTicial an ev � t eimi r� t ca e Fur erm re, I hereby agree that the city official or a designee may enter upon the prope�Ty to perform needed mspectiuns
X / �/1 �
Signature Contractor's License No Date
Permit Valua � ��' T 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 Perm�t Fee $ Water Tower Fee # $
Mechamcal Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permrt Fee $ TOTAL DUE $ �
This p cat' n B c es Your Building Pernvt Wh App ved Paid ReCel t No. �.
Date '3 . B
� Z7 i'?->
BuilJme Ut�ticia Da
�
This �s to c t tha he � t+c m[he abuve apphcahon and accumpanymg docum ts is m a ordance w�th the C�ry Zonmg Ordmance and may p�ocecA ati requcucd Th�s ducument
when s�g d y th iry � co sututes a tempu��yy Ceruficate of Zomng com iance a alluws consnucUOn tu commence Befuie uccupancy, a Ceruticate nf Occupancy must be
issucd
- � Z1 z �
P ning Director Da e Special Condrtions, if any
24 hour n icc for all inspections (952) J47-9850, fax (9S2) 4�7-4245
4646 Dakota Street Prior Lake, MN 55372
�
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS � `�c ���
TYPE OF WORK � �o �
USE OF BUILDING l��
PERMIT NO. _ � Z-r DATE IS UED � 27
BUILDER � PHONE # �-¢�—����-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
i�E oR �a�
FOOTING 3 /
� PLACE NO CONCRETE UNTIL AB E AS BEEN SIGNED
FRAMING
� ( �- L---
FINAL
FOR ALL INSPECTIONS (952) 447-9850