HomeMy WebLinkAboutBuilding Permit 14-1222 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 12"/Z (A-
ADDRESS 15"Z SI 'Pn►�S/°�N KS
ER CONTR.
4ONE NO. ' PERMIT NO. 1' - 17-2:2-
0
Z22❑ 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 GASUNE AIR TST
0-SITE INSPECTION 0 MECH FINAL 0
COMMENTS: W'I OD
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❑ WORK SATISFACTORY,PROCEED
CORRECT ACTIO AND PROCEED
❑ CORRECT;it R',A ALL FOR REINSPECTION BEFORE COVERING
Inspector. % / ' Owner/Contr.
CALL 44 .• s FOR SPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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()* Pl"° CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / O. j.q c- s�--AND UTILITY CONNECTION PERMIT
lrjNEsol� I White File
2 Pink �;tY PERMIT NO. 4 I l_�v
3 Yellow Applicanti
se type or print and sign at bottom)
1110
ADDRESS ZONING(office use)
15 Z$i la-644-. .s 7�'_ N
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) avu�S i� (Phone) 61?--3ir r—y3)-S
(Address) /5251 Tri,,-1,,K.f : /I/C:::
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ['Deck ['Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Addition ['Alteration ❑Utility Connection / ";•-(11,-)
�Misc. f e{7(CtCvJ"f ) 5145 C i3J�
CODE: ❑I.R.C. ❑I.B.C. f
41u
e of Construction: I II HI IV V A B PROJECT COST/VALUE $ 3, 00
c)
(excluding land)
pancy Group: A B E F H I M R S U
vision: 1 2 3 4 5
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 per... for Just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
IX
i i o%// /
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 $
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This Appl' tion Be ` e: our Building Permit When Appr i ved Paid ` S R ipt No. /Tz �,
/ (/ D Date /0 �- 1�.1 '
Building U mai Date
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
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
,sued
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