HomeMy WebLinkAboutBuilding Permit 15. 0633 of pe�o�P CITY OF PRIOR LAKE BUILDING PERMIT,
�. r TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Recd
AND UTILITY CONNECTION PERMIT �`�- ��
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I. While File I PERMIT NO./
3 Yellow City 633J
(Please type or print and sign at bottom) 3 Applicant
ADDRESS •
/ 'zJ 'L ( ( ZONING(office use)
v � �.I
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
BUILDER tt� / /� .�7
(Company Name)J0� •Fr 44 -,-i -f wn L_� (Phone) l7/C 3? - �/
Leg
(Contact Name) c1< C rAilt E `
(Phone)
(Address)
SLSS r10 4,, Tc I Lm ,fr �,t/ Sroq'
TYPE OF ORK 1:1 New Construction ]Deck ❑Porch
❑Addition ❑Alteration ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
CODE: .R.C. ❑I.B.C. ❑Utility Connection
❑Misc.
PROJECT COST/VALUE $
Type of Co struction: I II III IV V A B
Occupancy roup: ABE F HI MR SU
Division: 1 2 3 4 5 (excluding land)
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
official can oke this permit for just cause Furthermore,I hereby agree that the city officia or a designee may enter upon the,propeny to perform needed inspections.
X �•Vf 6f G/,AM
--
Signature
Contractor's License No. Date
Permit Valuation 1 0 00 00 Park Support Fee #
Permit Fee 7 $
$ /6)3_o0 SAC # $
Plan Check Fee $
(p(j 95 Water Meter Size 5/8"; I"; $
State Surcharge $
..00 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 ;
This Appl' �i n om-. Your Buil/ling Permit Whe Approv d Paid _�_
Affr / Receipt No.
i'I.(r� Date B //.�
�,
&ti Id'tl g Officio Date
This is to cerci requ the ab a application -r,ccom an in documents is i ccordance -ith the CityZoning Ordinance and may
when signed., ala, e cons 1 temporary Certificate of Zoning compliant rid allows nstruction to commence. Before occupancy,
issued y,ateed as requested. This document
ir •/ P< y. Certificate of Occupancy must be
Fanning Direc. Date
'lice for all inspections(952)447-9850,fax(952)447-4245 Special Conditions,if any
4646 Dakota Street Prior Lake,MN 55372
CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED "t c\ (S'
. ADDRESS ) 6 C 2( g £-L€ /� C�
OWNER CONTR. J�.
PHONE NO. PERMIT NO. I Li - qc ft S. �3.3
❑ FOOTING 0 PLUMBING RI 0 EX/GRA
I
FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
.. INAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ TE INSPECTION 0 MECH FINAL
COMMENTS: A-
GAD Af—/ 4-A.,,. -L.4, Cly
O
r:X "Ise—, -11, (2)-fzi —k-s-0 —
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
i<
O CORRECT ORK,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!
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1
P R I0 R LAKE BUILD NG A DOINSPECTION
INSPECTION
SITE ADDRESS
RECORD
4 A -- V
TYPE OF WORK
alAIT
USE OF BUILDING i
PERMIT NO. 'IL
BUILDER � DA E ISSUED
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS gEL O
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING 'MM. �INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGN D
10:1111111111111Mmoullialla10111
FOR ALL INSPECTIONS (952) 447_9850