HomeMy WebLinkAboutBUILDING PERMIT 16-1418 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS ) 7 '1 1'Z 0-WC . z
OWNER CONTR.
PHONE NO. PERMIT NO. 1 `� ' H QO
❑ 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 ❑ GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL
COMMENTS:
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: (Q Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
o� P R Ion 25/
�, 1, fie. CITY OF PRIOR LAKE BUILDING PERMIT, to Rec'd
�' . TEMPORARY CERTIFICATE OF ZONING COMPLIANCE i j1
AND UTILITY CONNECTION PERMIT
r`�'NE50
1. White File PERMIT NO.
2. Pink City I/ ,
L/77//
3. Yellow Applicant t7� C!
e type or print and sign at bottom)
KESS ZONING(office use)
7 / ; •Pc-C-2=7 t7i 5E, Px/np t M4; /4-\J s5- ,-2
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER fJ
(Name) ( 1`t-41" � (Phone) 0/2 7y.S.--e VC)
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ['Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish El Fireplace
DAddition ❑Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. 'Misc: sO1-/'1- 6t-
e of Construction: I H III IV V A B
pancy Group: ABE F HI MR SU PROJECT COST/VALUE $
sion: 1 2 3 4 5 (excluding land)
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 permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X (3)s_i__ _,,,_t&,.<----------- /
Signature Contractor's License No. Date
Permit Valuation Z 000, a v Park Support Fee # $
j
Permit Fee $ -73 , 2s- SAC # $
Plan Check Fee $ *-?✓ q ¢. Water Meter Size 5/8"; 1"; $
State Surcharge $ /V OD 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 $ /2,- - �O 9
This Application Becomes Your Building Permit When Approved Paid /Z.. & Rece..t ► o -Ad.-7 /
Date 7-c< 7"-- (� By 4i(k) 5 73 3 ----t
Building Official Date
IDto 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
igned 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