HomeMy WebLinkAboutBuilding Permit 15-0352 DATE TIME
SCHEDULEDC
INSPECTION NOT CE C4�/j
ZI-
ADDRESS
OWNER CONTR. ______A5-.:---3-5- 4---
0
�� � �L
PERMIT NO.
PHONE NO. ❑ GIZADIFILLING
p PLUMBING RI 0 XIGRADICE RI
❑ FOUN A 0 MECH RI 0 COMPLAINT
0 WATER HOOKUP 0 FIREPLACE FINAL
❑ FOUNDATION 0 SEWER HOOKUP
❑ FRAMING0 GASLINE AIR TST
❑ FINALLATION 0 PLUMBING FINAL �p
❑ SITE
INSPECTION 0 MECH FINAL �� C�
❑ SITE
COMMENTS:
Al WORK SATISFACTORY,PROCEED
b CORRECT ACTION AND PROCEED
0 CO (..22t.i.iL)
RRECT ORK,CALL FOR REINSPECTION BEFORE COVERING
pwner/Contra
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE!
HEALTH&SAFE
CODE REQUIREMENTS ARE FOR YOUR PERSONAL ILEAL
ration
ri PR/o.PCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
O. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4- 1..1�
AND UTILITY CONNECTION PERMIT
4/A'NESot� I. White File pERMIT NO. /5
2. Pink City '352
ase type or print and sign at bottom) 3 Yellow Applicant
0
S > /�je �/) l ZONING use)
S
�S
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 25. Z ZG _ a 1 Q 0
OWNER
".'-'17,..n
AJ/ `� / -
(Name)
/� (Phone)
(Address) !�'
BUILDER
(Company Name) (Phone)
(Contact Name)
(Phone)
(Address)
TYPE OF WORK ❑New Construction ❑Deck ['Porch [Me-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Utility Connection
4.1tu
CODE: ❑I.R.C. ❑I.B.C. isc. 4CA/141� �'re of Construction: I II III IV V A B /
panty Group: ABE F HI MR SU PROJECT COST/VALUE $
ision: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on this,..i, tion 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 co. orm to all existing state and local laws and will proceed ino accordance with submitted plans. I am aware that the building
official can revoke th=it forjust cause hereby agree that the city official or a designee may enter upon the property to perform ndfI •d ins 'coons.
X f 5
Signature Contractor's License No. Date
Permit Valuation a 1-252) Park Support Fee ## $
Permit Fee $ 1/z7 C .7 SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ :S d06 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 $ 19, 15-
This
9, 1$'This Application Becomes Your Building Permit When Approved Paid , Rec1ei6.3
. o.
l'-x}-15- Date -, ,� -�' _ By frit
Ildina Official(11L 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
red.
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