HomeMy WebLinkAboutBuilding Premit 16-1144 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED U.11441
ADDRESS \ '�' `Q'��} ®'�
OWNER CONTR.
PHONE NO. PERMIT NO. \ \. , \\`4`-
❑ 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 '4❑
COMMENTS: ,
is t‘-- - C -X. -
-- .,WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT ORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
of 'Rio CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /0. 3, /6
it AND UTILITY CONNECTION PERMIT
4r� sot[• 2.i.White air PERMIT NO. /6, i i 44-
(Please type or print and sign at bottom) Yellow ApplicantADDRESS ZONING office Use)
'4081 p12 2, p.io]I L.i , rn . 563)'
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER M
(Name) I 1 1 P1�� A- 4/114561j (Phone)
(Address) I tOV i mmotto 1 7v 1\ P<IDIZ LL ILS , m i . S537 a-
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK D New Construction :Week ❑Porch Roofing ORe-Siding ❑Lower Level Finish ❑Fireplace
DAddition []Alteration DUtility Connection / ,A�nn��CC
CODE: DI.R.C. DLB.C, 0 Misc. Q�G� rTG Gt7�2/& C1
Type of Construction: I II III IV V A B pp 0c
Occupancy Group: PROJECT COST/VALUE $ 1 V
Division:s A B E F H I M R S U (excluding land)
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
411
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 revoke this -t for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed insp ins.
X
Signature /n ;/1
gn Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC • # $
Plan Check Fee Water Meter Size 5/8"; 1"; $
State Surrti__ iCf-i fAl Pressure Reducer $
Penal �$� 1- Sewer/Water Connection Fee # $
Plumb ? ,•Orake.-foS 10 GO Water Tower Fee # $
Methal @GD1l1� BuiIder's Deposit $
Sewer& Mat�e� _ $ Other
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid /05'(A) Re ipt No. 70Z„S
Date /O ,I t(o
Building Official Date
This 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
when 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
all
issued.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372