HomeMy WebLinkAboutBuilding 11-1213 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED
1 �l�,
ADDRESS o2 a
OWNER CONTR.
PHONE NO. PERMIT NO. )j_ 21
❑ FOOTING 0 PLUMBING RI
El FOUNDATION
COMPFOUNDATION 0 MECH RI ❑ COMPA
❑ FRAMING 0 WATER HOOKUPLAI FILLING
NT
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE RI
❑ FINAL 0 PLUMBING FINAL 0 FIREPLACE FINAL
❑ SITE INSPECTION 0 MECH FINAL 0 GASLINE AIR TST
0
COMMENTS:
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0 WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT K,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!
INSNOTJ
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'( 9 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' AND UTILITY CONNECTION PERMIT
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1. white File IPERMIT NO.
2. Pink city /
3. Yellow Applicant , / I/ .�J
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
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C6a,c k rivxiki L.ct,,yz E-
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ^ � �� f f
(Name) Ol Ma..t kL (Phone) cia. yr/Y 7- 7--O 63
(Address) C./t)
BUILDER Renewal By Andersen
(Company Name) 1920 County Road "C"West (Phone)
(Contact Name) Roseville, MN 55113 (Phone)
(Address) License#20130983
651-264-4777
TYPE OF WORK 0 New Construction ❑Deck ['Porch ORe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplac �P_
❑Addition ❑Alteration ❑utility Connection '/ill `� - l� , /�(Jv, 'CU ..S A' I d o r
CODE: ❑I.R.C. ❑LB.C• 0 Misc.•W) ,n J ( Q/ —'I (' CjJ ,
Type of Construction: I II III IV V. A B �.J "� UU
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ /31 Sla-
Division: 1 2 3 4 5 (excluding land)
I hereby certify that 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 • ,perty and that all cons. will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware at the building
official can revoke ,' permit for just cause. ermore,I hereby agree that the city official or a designee ma enter upon the roperty to perform needed inspections.
X / ��cD t72l3O F3 /70 /1
Signature Contractor's License 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 $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid 71. 2 S eceipt No. (Q ye,7,/i
Date !l —1 i r
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