HomeMy WebLinkAboutBuilding Permit 16-1153 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED \
ADDRESS I 1-. / a 1,2. P
OWNER CONTR.
PHONE NO. PERMIT NO. ) Lo 5 3
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
iii(WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. CS7QL 4.i Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
"NSNOT,
O1 PR�o� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�• TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ,�
� � AND UTILITY CONNECTION PERMIT �� � y"� /4`
44/vNeso'0"
2.
1. whitePink File
I PERMIT NO./6
r //521
(Please type or print and sign at bottom) 3 Yellow Applicant +J"�
ADDRESS ,�
5 9,1 61-l-elC ll iACE 5E' ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK L ADDITION ��1 j 4./A-6-. R i 4.e. /14/,;"� l KPID ' 3/6 G)0?3"-O
OWNER
M
(Name)
Mari( &'J2 t�
i (Phone)
(Address) _.5-9.. 1 Ori-01,Q. P//t(e $
BUILDER
(Company Name) P oo-r 7,i Nt e 1-11
CI)(Phone) �-� L/47- 7663
(Contact Name) ft/1/k/. t/o..s,,;k—
(Address) 6j/90 ),JA 7� /r. fl'%o r L,A m N 3:5-3 7 (Phone) 61/-C-- — 99 '8�
TYPE OF WORK 0 New Construction ❑Deck
❑Addition DAlteration Porch Re-Roofing ORe-Siding ❑Lower Level Finish ❑Fireplace
❑Utility Contfction
illit
CODE: I.R.C.Construction:❑I.B.C.
0 Misc.
ype of I II III IV V A B
ccupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ i� 5-1(9(,/ivision: 1 2 3 4 5 (excluding land)
I hereby certify that I have fiimished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner to 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 permit for Just ause. Furthermore,I hereby agree that the city official or a designee may enter upon the property P P rte to pet-form needed inspect ins.
xS4le% /6
Signature
Contractor's License No. Date
Permit Valuation
Park Support Fee # $
Permit Fee $
0SAC # $
Plan Check Fee $
7 Water Meter Size 5/8"; I"; $
State Surcharge $ 0
!1� Pressure Reducer $
Penalty $ r ` (J
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 $ $(O , /t OO
TOTAL DUE L-/�
This Application Becomes Your Building Permit When ApprovedPaid 1 0 LI` 0 vi Date l Receipt No. l®
-( fly_ S y.,
Building Official Date �® V
kIS 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
li
en signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Cerhticate of Occupancy must be
ed.
E
Planning Director Date
24 hour notice for all inspections(952)447-9850 Special Conditions,if any
•
4646 Dakota Street Prior Lake,MN 55372