HomeMy WebLinkAboutBuilding Permit #12-178 CITY OF PRIOR LAKE DATE TIUAE
INSPECTION NOTICE SCHEDULED C� 3d �
ADDRESS �.�j � �� � �^ � G Q
OWNER CONTR.
PHONE NO. PERMIT NO. `2 -- � � �
-- --r--
� FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
�Q FINAL ❑ PLUMBING FINAL ❑ GASLlNE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
� WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORREC ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. OwneNContr:
CA 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH d� SAFETYl
INSNOTI
o � pR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �r
'��NNES°�� 2 I'�n c� Y PERMIT NO . CZ i
; Yellow App6cant
Please e or rint and si at bottom)
� ADDRESS ZONING c��" �s��
L r �` .
J� —f— v,�U� ��/1 c c� �a�' � ,� ��
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
� OWNER `' � j �AG- G �� / f�c C � � / ( ) Q S �I / ' 5�75�S
(Name) �/ � Phone ,_
�,q �E � s/ � �- . 2 ¢��
(Address) �'t� �Lt
BUII,DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK �ew Construct�on ❑Deck ❑Porch ❑Re-Roofing ❑Re-Sid�ng ❑Lower Level Fm�sh ❑ Fireplace
dd�t�on ❑Alteranon ❑Utiliry Connecaon
CODE: �.R.C. ❑I.B.C. ❑ M�sc.
Type of �onstruction: I II III IV V A B pROJECT COST/VALLTE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby cernty that I have hamshed mformanon un th�s appLcauon wh�ch is tu the best of my knowlcdge true and correct 1 also ccrufy that 1 am the owner c» authonzed agent for thc
above-mentio propc�ty and that 1 consnucuon will conform to all existmg state and local laws and will proceed m accordance w�th +ubm�tted plans I am aware that the bwldmg
nff'ic�al ca v e th s peimrt or i cause Furthermore, I hereby agree that the ciry official ur a des�gnee may enter upon the p�operty to perform necdcd mspccuuns
X '
Signature Contractor's Luense 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 $�� G' ,�-� Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
�
This A at' Becomes Your Building Permit en A roved Paid �7 ReCel t NO.
3 ' ( 2— Date � B '
a �,�_ urr����� ��c
Th�s �s to ce that � requcst`n the abuve applicat�on and accompanymg d uments m accordance w�th the Gry Zumng Ordmance and may procecA a� �equc�ted Th�s document
when s�gn y th� >nsUtutes a tempoiary Ce�uficate of Zonin compha ce and allows consn'ucuon to commence Before uccupancy, a Cc�uticate uf Occupancy must bc
ISSUI'd �
V'
ning Directo Date Special Condihons, �f any
24 hour noticc for all inspections (952) d47-9850, fax (9S2) 4d7-4245
4646 Dakota Street Prior Lake, MN 55372
DEP�►RTMENT OF
P� I R LA K E BtiJILDING AND INSPECTION
INSPE TI N
RE ORD
SITE A
DDRESS Sv� Nl1 i.4-N � c D ��.� C�/r .��',
NATURE OF WORK . S` X' o�
USE OF BUILDING //`E �-
PERMIT NO. �?--- I�I �S DATE ISSUED 3(� ��'
CONTRACTOR .'7�4-�--� PE-'r'2� (�-N PHONE ��{ -� s� `�-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
' to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
- PTIC
FRAMING � � ��.;'` . !,%,,,-
INSULATION n, : ° � �
ELECTRICAL
PLUMBING ��%�� -1', �`,>,.__� - �
if required) �
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
rior to Sodding)
BUILDING /
�LECTRICAL
P�UMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850