HomeMy WebLinkAboutBUILDING PERMIT 16-1092 DATE
TIME
CIN OF PRIOR LAKE
SCHEDULED
INSPECTION NOTICE A1)12ADDRESS 138g 6 116J
OWNER
CONTR.
PERMIT NO.
❑ EXIGRAp►FILLING
PHONE IN 0 COMPLAINT
❑ PLUMBING RI ❑ FIREPLACE RI
0 MECH RI NT FINAL
❑ FOOTING ❑ WATER HOOKUP ❑ FIREPLACE yi_
❑❑FOUNDATION
FRAMING ON ❑ SEWER HOOKUP 0 IREPINE AIR NAL
❑ INSULATION 0 PLUMBING FINAL
FINAL 0 MECH FINAL
❑ SITE INSPECTION
COMMENTS: p_, ,[w%j:
v •
WORK
SATISFACTORY,PROCEED
PROCEED
❑ CORCOVERING
Inspe• '
/,
0 CORRECT ACTION, ND
FOR REINSPECTION BEFORE
' T WORK,
OwnerlContr.
DVANCE•
Or
CODE REQUIREMENTS
C. 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN
H&SAFETY!
MENTSARE FOR YOUR PERSONAL'
INSxor1
icPRtp� CITY OF PRIOR LAKE BUILDING PERMIT, q."'''
Date Recd
A. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
NESOl� 1. White FilePERMIT NO.2. Pink City //` / / q"73 Yellow Applicant `+r I �/ (.�type or print and sign at bottom)
ADDRESS ZONING(office use)
13826 KENSIGTON AVE NE., PRIOR LAKE, MN 55372
RI
LEGALDESCRIPTION(office use only)
LOT `I BLOCK Z- ADDITION a.///ti b 56 CS 4 7' PID G5 V/3 -0/3-0
-0
OWNER
(Name) HOLLANDER MARK (Phone)
(Address) 13826 KENSINGTON AVE NE PRIOR LAKE, MN 55372
BUILDER
(Company Name)SMART BUILDERS, INC (Phone) 952-292-9210
(Contact Name) ISAAK CHUK (Phone) 952-292-9210
(Address) 11672 BUTTERNUT ST. NW., COON RAPIDS, MN 55448
TYPE OF WORK ❑New Construction ❑Deck ['Porch yjRe-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ❑Alteration I:1 Utility Connection
4;toDE: ❑I.R.C. ❑I.B.C. ❑Misc.
e of Construction: I II III IV V A B PROJECT COST/VALUE $ 7900.00
panty Group: A B E F H I M R 5 U (excluding land)
•
isio1 2 3 4 5
I hereby certify that I have fimished 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 this permit for just cause. Furthermore,1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x BC639139 9/19/16
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ /'S 7� Water Meter Size 5/8"; 1"; $
State Surcharge $ 10 -(76 6 Pressure Reducer $
Penalty $ G, (r) 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 $/9//e
This Application Becomes Your Building Permit When Approved Paid /D 171' 0 O Recei No. 'S-r*/
Date eq_ Z Z. /C By (p
Building Official Date
liks 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
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
issued.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372