HomeMy WebLinkAboutBuilding Permit 16-1139 DATE TIME
CITY OF PRIONOTICELR AT SCHEDULED424fr -----
INSPECTION
ADDRESS
k Lt
OWNER CONTR.
PERMIT NO. � tC ��'�
PHONE NO.
0 PLUMBING RI ❑ EXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FOUNDATION 0 FIREPLACE RI
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE FINAL.
❑ INSULATION 0 SEWER HOOKUP 0 IREPLA AIR TSL
❑ FINAL 0 PLUMBING FINAL
❑ SITE INSPECTION
0 MECH FINAL �Zc
COMMENTS: ilt
1
6 YORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
0 CORRECT WO K,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contra
Inspector.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS ADVANCE.SAE !
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL
INSNOTI
of Paio�P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT .7' 36. / 1
• ♦�� nle/oe' I. white File
2. Pink City PERMIT NO. 16, 1/3q
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
\ 4 L l End av€, c+Nivv P
•
LEGAL DESCRIPTION(office use only) /,g:e14-'C-15
LOT /aOCK ADDITION �%1��' AA-C1 / PID Tis '" `/37--be9'-0
OWNER
(Naf`-°f Wt (Phone) La 127101-71
(Address) I`I 141 j.C.l:t --e, (+ N Wior Laic rrIN 55312
BUILDER
(Company Name) R9 con-erCu-tl et) (Phone) ((o3 Zq 5 306
(Contact Name) OJ'\ ' '\Thk (Phone) CQ j? 2-E,)(al
(Address)V34 .y.)411e.., AUS. k Ot'Sex % CYN 10 5C,) P Z
TYPE OF WORK 0 New Construction DDeck ❑Porch ,Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
411; ype
DAddition DAlteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. 0 Misc.
of Construction: I II III IV V AB I1- ��l�
cupancy Group: ABE F HI MR SU PROJECT COST/VALUE S
(excluding land)
ivision: 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- tioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
official i o e th' it to;just c e Fu ermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature Contractors License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC •
# $
Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ U`� Pressure Reducer $
Penalty $ ( 0 Sewer/Water Connection Fee # $
Plumbing Permit Fee $
1.-
Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $1//0 1 t Od
This Application Becomes Your Building Permit When Approved Paid (0 /l '" 0° ,Receipt No. 76/ /57
Date qY ry /6 By S 3....---
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
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
ucd.
• Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372