HomeMy WebLinkAboutBUILDING PERMIT 16-1070 DATE TIME
CITY PRIOR LAKE
INi�Y
INSPECTION NOTICE SCHEDULED -114
ADDRESS 5-412. /�►w+4 (J
OWNER CONTR. /
PHONE NO. PERMIT NO. I6 — Curb
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
FINAL
0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION0 MECH FINAL 0
COMMENTS: WI
1 +
akehe,,A0
❑ WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
❑ CORRE RK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: 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 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
• 401VE5O'S?* I. White File
z. pink city PERMIT NO. // (076
3 Yellow Applicant
IR
ase type or print and sign at bottom)
DRESS ZONING(office use)
5(1/ R Ainbta. wood Di rc. NE
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER 8con don J b /) l. s 9521 aro . QS32
(Name) (Phone)
(Address) 5 Y1 2 A in b IL co O 0 d Di'i v C, NE
BUILDER Pella Northland
(Company Name) 15300 25th Ave N. Ste 100 (Phone)
(Contact Name) Plymouth, MN 55447 (Phone) 952/3 '1$ ' L C Y 7
(Address) Lie# BC645090 Ph. 763/745-1400 JpdI
TYPE OF WORK ❑New Construction ❑Deck ❑Porch DRe-Roofing ❑Re-Siding ['Lower Level Finish ❑Frireplace
❑Addition DAlteration ❑Utility Connection a W n W 9 „ I p a�!a U p 0�'
CODE: ❑I.R.C. ❑LB.C. Mise. r • 1 t ppl 6 I !A I
(excluding land)
e of Construction: I II III IV V A B PROJECT COST/VALUE $ 7 L1 a 9
panty Group: ABE F HI MR SU
ivision: 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 this t f just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed ins echons.
�- cey � 4 � gj � �� i.
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 ` $
This Application Becomes Your Building Permit When Approved Paid fog_ ( o Re rpt No. (a q6,7
Date Cj 4,3 ,J 6 y -
Building Official Date 1 l`
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
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
.sued.lik
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake.MN 55372