HomeMy WebLinkAboutBuilding Permit 14-1268 DATE
TIME
CITY OF PRIOR LAKE \\-j.
INSPECTION NOTICE SCHEDULED `, t 'L L j
ADDRESS .S ICI g"
OWNER CONTR.
PHONE NO. PERMIT NO. r 2-0' -'
❑ 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 ❑ ASLINE AIR TST
❑ SITE
INSPECTION
0 MECH FINAL i
l
r
COMMENTS:
.
llfORK SATISFACTORY,PROCEED
❑ CORRECT
ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. 1 � � _ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE
REQUIREMENTS'ARE FOR YOUR PERSONAL HEALTH&SAFETY! it
ration
(**--
PR fob CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE //` ft,/
(`;;0AND UTILITY CONNECTION PERMIT
l
I. White File T
M�NNESO�� 2. Pink City PERMIT NO./4---C �� ,-V
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS -
(office use)
6 ( oa, cv (2,4i)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID zjs- ii )a ( . 6 13 - 1
OWNER 5
WL.. LA& (Phone) / l ' A) 1y
(Name) , ' Phone
, ..
(Address) 5-1 0 s C,.,.J' J ‘s.-_ 1 \ 4
AAD
BUILDER —
(Company Name) _fe;' _ - abA V o
36C1_
' Sllc"- (Phone) r 3(6 0(Contact Name) A c7 \ '50- "\ (Phone) C 1,..36, -.36/0
(Address) `�C) �p)c 6c1,7"7 ( :4__ l r"
TYPE OF WORK ❑New Construction ['Deck ❑Porch DRe-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
['Addition ['Alteration ['Utility Connection n
3k.it
CODE: ❑LR.C. ❑LMisc. 'j vi✓B.C. '.^^ �
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ V I Cor')r ``"
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I I hereby cert.' that I have,t(itrnished 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- tio d r er 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
officia a .r'evok th s r t for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature Contractor's License No. Dat
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 $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE When 7 $
Rec:f.t No. C/
--7
This Application Becomes Your Building PermitApprovedPaid C `
Date /w re,//T 4
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina, and may proceed as requested. Th is 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