HomeMy WebLinkAboutBuilding Permit 15-0192 DATE TIME
CITY OF PRIOR LAKE SCHEDULED
INSPECTION NOTICE
ADDRESS 173/Z-- Dear-1,,t&
1241)
OWNER CONTR.
PHONE NO. PERMIT NO. / - / �1 2-
• FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI • 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL
0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL
COMMENTS:
,®"(WORK SATISFACTORY,,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSHOT1
tnt CP1t�o�P CITY OF PRIOR LAKE BUILDING PERMIT, Dane Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 3 /S
...„..."
AND UTILITY CONNECTION PERMIT
ESolP I. White File
2 Pink City
PERMIT NO./5 / ►a
3 Yellow Applicant
(Please type or print and sign at bottom)
•
ADDRESS . ZONING(office use)
173/z A,,- Adi4,, St /'i�,,„,, LQCc, iw/, 5:1---(72--
LEGAL
'.s'-(7LLEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ..-/f 5�4L' <ritc G✓RC1 C. (Phone) 1S G "f(�7r el‘ �r
(Address) SY vti,tiL
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address) ,
TYPE OF WORK ❑New Construction ['Deck ['Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
['Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. Mist. SU t Tv 86
Type of Construction: I II III IV V A B PROTECT COST/VALUE $
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the ,
above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
1 official can rem."e this permit caus Elul rmore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X / �7�� )-_‘—/-5.
Signature Contractor's License No. Date
Permit Valuation Zi 000.60
Park Support Fee # $
Permit Fee $ 73. 75" SAC # $
Plan Check Fee $ ¢? G¢ Water Meter Size 5/8"; 1"; $
State Surcharge $ / 070 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 $12-2, 6, 'A
This Applica�t Becomes Your Building Permit When Approved Paid /2... ...67 17¢•
Rif No.
I3 , 4 ,t r Date 3„ .c? 1 f B •
III I l me Ofticial Date
This is to certi that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372