HomeMy WebLinkAboutBUILDING 15-1137 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED 3 2� 1
ADDRESS f7(9 '
OWNER
CONTR.
PHONE NO. PERMIT NO.
❑ FOOTING 0 PLUMBING RI
❑ FOUNDATION 0 MECH RI ❑ COMPLAI FILLING
0 COMPLAI
❑ FRAMING 0 WATER HOOKUPNT
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE
❑ FINAL 0 PLUMBING FINAL 0 FIREPLACE FINAL
❑ SITE INSPECTION 0 MECH FINAL ❑ GASLINE AIR TST
COMMENTS:
A.,fl G�� ,
OIL -63
j5-4ORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector:
-- Owner/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
•
O 4
7
of PR1� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
ti AN TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT q 2 S�
so �'N E SO
2.white Cityie PERMIT NO. (�l f3 7
2. Pink
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
I'/0S0 )/13- Tr-z ( )Pt-' A /sA
LEGAL DESC ION(office use o •
LOT BLOCK ADDITION PID •1/2 "" /'-' 4—1
OWNER Ni#n (.L 4 r- (.�14, (Phone) Z c 7 I. '"!,l - - 1
(Name) v
(Address) 1701 0 •-/ASP,,,.. 'Tr,l Li/ k"C.Jr /74f C, } 3 7 Z
BUILDER tit l juLt //JO('t em -7 70 -'7,Oa'
(Company Name) / (Phone)
(Contact Name) ��4/1�0.-/�1� (Phone)
(Address) 2-2.l I l�(/ Ave- 6 � � /:�� /1 /�4.�/( ;
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ❑Re-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection
Illiirp
� w l,► 1 ws "kI p4--i-,b 1°C.
ODE:• I.R.C. I.B.C. [�Misc: 2
e of Construction: I II III IV V A B 6 )
ccupancy Group: A B E F H I M R S U PROJECT COST/VALUE $
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 revoke this mu r Just cause. urther re,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
_ & 356&47 y'- / I/—i,5
R
SignatureContractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ / Water Meter Size 5/8"; 1"; $
State Surcharge $ r Pre Reducer $
is;" 60
Penalty $ Ill li , Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other "9 C:
17_,\
Gas Fireplace Permit Fee $ TOTAL DUE $
C�
This Application Becomes Your Building Permit When Approved Paid 16—` J ' Receipt No.
'24 ri ,
Date C 1 By
Building Official Date
is 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
411!1k
en 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.E.,Prior Lake,Minnesota 55372