HomeMy WebLinkAboutBUILDING PERMIT 16-1102 ATE TIME
CITY OF PRIOR LAKE SCHEDULED �� (40INSPECTION NOTICE
ADDRESS ^r 8 I ft: ,..k P
u
OWNER CONTR. //�
PHONE NO.
PERMIT NO. �lD"
0 PLUMBING RI 0 EXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FRAMING ❑ WATER HOOKUP
❑ FOUNDATION0 FIREPLACE RI
❑ FIREPLACE FINAL
❑ INSULATION 0 SEWER HOOKUP 0 GASLINERELA AIR TSL
❑ FINAL 0 PLUMBING FINAL 0
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS: '1, - .,..c
it. PAM
0 ( , OYLS•
WORK SATISFACTORY,PROCEED
❑ CORRECT ' • AND PROCEED
❑ CORREC WO'i ALL FOR REINSPECTION BEFORE COVERING
Inspector i Owner/Contr:
CALL '850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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l0 PRIo4) CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�i /1\ ,.rr
TEMPORARY
CERTIFICATE OF ZONING COMPLIANCE
�f \)i AND UTILITY CONNECTION PERMIT
NNEs°
L White File
2. Pink City PERMIT /`'�/NO. // //60_,
3. Yellow Applicant
type or print and sign at bottom)
ZONING(office use)
le
RESS
/ 681- A. 4.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER q
(Name) re-i ,..7;111456v, (Phone)
, P �'
(Address) /SOo di ®4'. 1` 4. /e L 0///x)
BUILDER
( ��2- y C' 66(f-(Company Name) ►4 "4S�- (Phone)
(Contact Name) (Phone)
(Address) 247 3 l 6c44.f &c/ w MI" sJ'.53'2...-
TYPE OF WORK ❑New Construction ❑Deck ❑Porche-Roofing DRe-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ['Alteration DUtility Conne tlo
CODE: ❑I.R.C. ❑LB.0 ❑Misc:
T e of Construction: I II III IV V A B PROJECT COST/VALUE $
iipancy Group: ABE F HI MR SU
ion: 1 2 3 4 5 (excluding land)
I hereby certify that I have fumished 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 proper..id 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 thi, for just caus Furthe ir-,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
% 44 Y 4 Signature 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 $ /0
This Application Becomes Your Building Permit When Approved Paid /)�472., ipt No. & 91
Date 2 _/ k
6,: is-a?
Building
,-
Building Official Date
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
gned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
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