HomeMy WebLinkAboutBuilding Pemrit 16-1128 DA E TIME
CITY PLASCHEDULED /
INSPECTIONOF RIOR NOTICEKE
ADDRESS C 1 -7 4' L1/41-41"Ki-
OWNER
OWNER CONTR.
PHONE NO. PERMIT NO. 7 _ 7/a Il
❑ 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 ❑ foASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS: _7
❑�cORK SATISFACTORY,PROCEED
ORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. ®9_ V Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
WSNOTI
P R I��P CITY OF PRIOR LAKE BUILDING PERMIT Date Rec'd
,f 1 \ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
'`� AND UTILITY CONNECTION PERMIT Gj Z7. /e7
\r�'N E SOS
I. White File
2. Pink City PERMIT NO. / , 7/
3. Yellow Applicant
ase type or print and sign at bottom)
DRESS ICl/76 ,- /oJ7e i. ' /1ALL) .s
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER fn 1
(Name) UC !'r 1'Jd y g l 1,C.ti�A ) )14.3 4. 'O ) (Phone) q 5 A- f--"` '3`l 23__
(Address)
—
(Address) 1 6 Li'7 - /6 V /0> Fitx 4,
BUILDER ,
(Company Name) aieVi.i..r› - R Zr-Y1 (Phone) 9.5:4- 1)y7-CL7 L/
(Contact Name) ,rd . Ari7,0/ (Phone)
(Address) 8/46 Ce1,) �2 c>' ,hod-35S' cen44G ,e,T./
TYPE OF WORK El New Construction ODeck ❑Porch DRe-Roofing )(Re-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ['Alteration ['Utility Connection /�
CODE: ❑I.R.C. ❑I.B.C.
❑Misc:
Type of Construction: I II III 1V V A B
pancy Group: A Instruction
F H I M R S U PROJECT COST/VALUE $
Sion: 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 prop , . t all construction will conform to all existingstate and local laws and willproceed in accordance with submitted plans. I am aware that the building
liwi
official can rep.' i'/just caus- Furthermore,I herebyagree that the cityofficial or a designee mayenter upon the roe toperform needed inspections.!3LSLi J / +� g P property rtY P
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 $ /a 0 0
This Application Becomes Your Building Permit When Approved Paid /Q tk Rec pt No. 7O/I
Date l.- ,l( B -
Building Official Date
le• 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
igned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372