HomeMy WebLinkAboutBUILDING PERMIT 16-1303 CITY OF PRIOR LAKE
INSPECTION NOTICE DATE TINE
SCHEDULED l `S 1
ADDRESS 2?S81..ne Ls / `+"
OWNER
CONTR.
PHONE NO.
PERMIT NO. ((;,/3°}
❑ FOOTING ❑ PLUMBING RI
❑ FOUNDATION ❑ RAD/FILLING
❑ MECH RI COMPLAINT❑
❑ FRAMING
❑ INSULATION 0 WATER HOOKUP
Ce-FINAL SEWER HOOKUP 0 FIREPLACE RI
0 PLUMBING FINAL 0 FIREPLACE FINAL
❑ SITE INSPECTION0 GASLINE AIR TST
0 MECH FINAL
COMMENTS: ❑
�1c WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
0 CORREC '••RK, - •LL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr.
---------._____-
CAL ,447_9850 FOR THE NEXT INSPECTION 24
HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL
HEALTH&SAFETY!
1n'SNOT1
Off:PR 04,
V l CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
-. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
U �' i AND UTILITY CONNECTION PERMIT
/(_ 7, I6
r4'NESC�
I. White File .PERMIT NO
2. Pink City '
ease type or print and sign at bottom) 3' Ye��O� APPS cant
DRESS
66,�� -�i-•
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) iLk -r-
(Phone)
(Address)
BUILDER Polar 1ull*rs Inc.
(Company Name) 1103 W.Bumsw il.Pkwy, Saila 110 (Phone) 6.('2L�.'3`Z'3 t 00
(Contact Name) Burnsvl/N,MN 55337
952-895-9199 / MN LIc 0 BC 139097 (Phone)
(Address)
TYPE OF WORK 0 New Construction ['Deck ❑Porch .Re-Roofin
❑Addition. . ['Utility Connection
I H III IV V A B
DAlteration g ❑Re-Siding ['Lower Level Finish ❑Fireplace
CODE: ❑I.R.C. ❑I.BC
4110 Type of Construction: ❑Misc:
ccupancy Group: ABE F HI MR SU PROJECT COST/VALUE $
ivision: 1 2 3 4 5 (excluding land)
I hereb -•'• that I have fumis -. formation•. . app I . on which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
a.. ..!' ee •• at all cons. on will co t to all existingstate and local laws and will proceed in accordance with submitted plans. I am aware that the building
• `j ��_ .r just caus:. Furthe I.! hereby agree that the cityofficial or a designee gnee may enter upon the property to perform needed inspection.
, 7 /
Signature ( ��
Contractor's License No. ate
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 $ (0 r-�)
This Application Becomes Your Building Permit When Approved 732-Z---
Date
��� (/
Paid �� Receip o. / �i
Date //_1 _` By
Building Official 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
en 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
'is
ed.
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