HomeMy WebLinkAboutBUILDING PERMIT 16-240 DATE TIME
CITY OF PRIOR LAKE SCHEDULED b ►
INSPECTION NOTICE
ADDRESS L) f,
OWNER CONTR.
PHONE NO.
PERMIT NO. `
0 PLUMBING RI 0 EXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FOUNDATION0 WATER HOOKUP 0 FIREPLACE RI
❑ FRAMING FINAL 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑
❑ INSULATION FS0 MECH FINAL
0 PLUMBING FINAL 0 ASLINE AIR TST
❑ SITE INSPECTION �s=
COMMENTS:
1
*WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contra
CALL 44T-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
O� PRtp�
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
, r TEMPORARYAND CERTIFICATE
UTILITY OF ZONINGCONNECTION COMPLIANCEPERMIT 3_ 3 0 . /(a .
U ts7
I. white File I PERMIT NO. lea 04-044NEsO�� 2. Pink City
3 Yellow Applicant r
se type or print and sign at bottom) ZONING(office use)
DRESS 356 U cSP/w e 7-7 /C/
LEGAL DESCRIPTION(office use only)
PID Z3, 1-7Z• 6 0
LOT BLOCK ADDITION
OWNER
(Name) / ' j /S NG tLe/ 1 (Phone) 1957?—3 "7873
(Address)
BUILDER (Phone)
(Company Name)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ❑Re-Roofing e-Siding ❑Lower Level Finish 0 Fireplace
CODE: DI.R.C.
DI.B.C.
❑Addition ❑Alteration ❑Utility Connection
0 Misc.
e of Construction: I II III IV V A B PROJECT COST/VALUE $
)k
panty Group: A B E F H I M R S U (excluding land)
ision: 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
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 t ermit f` cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Gam— 3/i'�/.201 fo
X - Contractor's License No. Date
Signature
Permit Valuation $
�/ s-3---)v
�7),_up Park Support Fee # $
Permit Fee `(J„7 00 SAC # $
Plan Check Fee
$ .,....---' Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
C/ 62.)
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 $ /6 4_
I
This Application i e t'',es Your Building Permit When Approved
Paid //)1".0
I
Date 3 30. ( 4 1 yRece t No. � a
7B
\ .i , 33o �1b
Buil `')ftiei. Date
s to certify that e request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
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
ed
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372