HomeMy WebLinkAboutBuilding Permit 16-0955 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /O
ADDRESS S3 1Z
OWNER CONTR.
PHONE NO. PERMIT NO. i L Q51,--
❑ 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 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: g--z
& —
\ -t. '‘J t 5 f G t& J. in.- ,10: -
rel fi ./(
❑ WORK SATISFACTORY,PROCEED
1QORRECT ACTION AND PROCEED
O CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. rG�Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
hVSNOTI
�� .\ CITY OF PRIOR LAKE BUILDING PERMIT,
\ , TEMPORARY CERTIFICATE OF ZONING COMPLIANCEDate Rei
AND UTILITY CONNECTION PERMIT l�✓
,kiv E S O°r7t• (6
1. White pile
z. Pink City PERMIT NO.
e e or "'it and si n at bottom) 3. Yellow Applicant ��,` I
1 RESS
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
PID
OWNER 1 1
(Name) T. '
(Address) 11 �{'�i�l'1► i
(Phone) 64? -50-‘37g,6
S �11a c50v",^1", S7s
BUILDER
(Company Name) 7-C,.c-e. . X f.r+ o fs a C M
(Contact Name) p- � (Phone) 7 6 3 -)7/- g 7 C'' )
(Address) J(Q (Phone) 76 5--20a_0 6 i 6
,
TYPE OF WORK 0 New Construction
['AdditionDDeck OUt P Connec orch Re-Roofing Re-Siding ['Lower Level Finish ❑Fireplace
DAlteration �,
n
CODE: I.R.C. I.B.C.
T pe of Construction; 0 Misc:
I II III IV V A B
pancy Group: A B E F H I M R S U
PROJECT COST/VALUE $ / 00 0
(excluding land) 1
.ion: 1 2 3 4 5
I hereby certify that I have famished info.,ation. .is.p.,cation 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 �nstruM-bn c.
official can revokeonthis t a t form to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
P �,'.use i/ hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X �/i 6 3s �7
Signature �' oC y-�
Contractor's License No. Date
Permit Valuation
z-S'7JZ) ,111.E Park Support Fee # $
Permit Fee
$ /U> -- 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 $ Pi/. OL)
This Application Becomes Your Building Permit When Approved � '��
I Paid �Q G'TJ I Rec ipt No. 6,6j
c/ I
Date r, �.�, f' gy
Buildin. Official Date
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