HomeMy WebLinkAboutBUILDING PERMIT 16-0966 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Ct)3o��lo
ADDRESS / L9 Cf 7m2,/04
OWNER CONTR.
PHONE NO. PERMIT NO. !O - cl krt.
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
pr4-WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector. C:a) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
OF PR./0 4t i 0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�' TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
.1.0-
r.;
, c
x AND UTILITY CONNECTION PERMIT
v �,
iii
��HNES���
I.w"`" File PERMIT NO.
2. Pink City /�
3 Yellow Applicant
(Please type or print and sign at bottom) •
ADDRESS ILA., ZONING(office use)
•
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)OWNEDeAnni c er I V (Phone) 0,Y't�— IR —()1 1 t-l)
(Address) ' LI Cl `I c ci 3, -\-y--c `i
BUILDER(Company `,, ,,1 (0 1r}--011—U/ 9
1
(Company Name).} ��Y�� � '� (Phone)
(Contact Name) 1`e �1 CA .gl+�(��3� V (Phone)LP 1"d" 0-1-1-0'//Y i
(Address)1)-419-LI pvVlfi Ut,1'\-Q-,• Si- •�1'I 4d „P-441/ X)l-.P ( -,- 6—// 7�0
TYPE OF WORK 0 New Construction ['Deck ❑Porch ❑Re-Roofing /•'e-Siding ['Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ['Utility Connection 44cc1 �—
iii
re-
CODE: DLR.C. �LB.C. ��� 42).Type of Conshnction: I II III IV V A B PROJECT COST/VALUE $ l_(/.1 '-�
Occupancy Group: A B E F A I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information un 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 andthat 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 revo permit loclust taus F ermore,I her agree that the city official or a designee may enter upon the property to perform needed inspections.
7D —
Signallure Contractor's License No. Date
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 $
This Application Becomes Your Building Permit When Approved Paid 10-f (1?) Receipt N 670?
Date 0_ 7,c, 16 By
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
issued.
• Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850 •
4646 Dakota Street Prior Lake,MN 55372