HomeMy WebLinkAboutbuilding 11-1053 DAT TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED f 25 7
ADDRESS 7(a.3 . e 1 . -P V�71-1—
OWNER • CONTR.
PHONE NO. PERMIT NO. 1( -- In '
❑ 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 0
COMMENTS:
must-
•
•
•
❑ WORK SATISFACTORY,PROCEED
❑ CORRECT A •N AND PROCEED
❑ CORREC •-K,CALL FOR REINSPECTION BEFORE COVERING
Inspector: dr/ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
`" AND UTILITY CONNECTION PERMIT
f1:1NESC:S
1•white File
2 Pink City PERMIT NO. /0, .., 2
i ,,3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5 32- a.)` ';11'4SeaCii--%T-i SU, Fraov 'ae 553-2 2--
LEGAL
5322--
LEGAL DESCRIPTION(office use only)
LOT
�� D
'.'�r�� BLOCK ADDITION PI
DOWNER
(Name) Mall fel 4 ca-Leil-e. tvv.;_ ,ev- (Phone) i-30 9 -3 L 9 -85 j
J
(Address) 3 6 3'7. +(10A) e Ui-, it-4 5'0) R.-i or 1.: '.0 Yn PJ 37 2-
ER. (1161#1k1 -c175ia..:
(Company Name) C.YicA?tt_ Q t5fru.0 o, (17 "Tr•t_ (Phone) q52- 443 •-9I`r'ci
(Contact Name) Ke v ir t „a rz c01,x.._ (Phone) 6/2 36 3 43 i,-o
(Address) 5 r Z L..1ylr 9i., Av,e Gin tic, ,-i,-;1�.:+ A) �' -
TYPE OF WORK ❑New Construction ['Deck ❑Porch ❑Rc-Roofing ❑Re-Siding OLower Level Finish ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: [JLR.C. DI.B.C. *misc:in5b.,l 17 rep aCEtr i- Iltetr{44,/S
Type of Consttuctiion.: I II IIIIV V A B t s•eplrc 'ner^.4- .'ire Cot ,f E REPIAtenfarfs GrJLr-
Occupancy Group: A B E F HI M R SU I PROJECT COSI'/VALUE $ /0, 970. 1110 RtS'QAri,,,
Division: 1 2 3 4 5 (excluding land) 1
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 a ng state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official-can revoke ttthrrrm
iiye ,it four just Furthermore,cause.f` _ I hereby agree t the city official or a designee maay'/enttr upon the property to perform needed inspections. /
Signature f Contractor's License No. Date
Permit Valuation. Park Support Fee # $
Permit Fee $ SAC # 1 $
• ^r^^rl,,,-g-P Pr. 5 Water Meter Size 5/8";1"; I $
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 Per t uit Fee $ TOTAL DUE $
Ir
This Application Becomes Your Building Permit When Approved Paid / ' , ,/t' Re,L4ipt No. '04-6-7
Date t' I/ _BY`_.
Building Official Date ""
This is to certify 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 S.F..Prior Lake,Minnesota 55372