HomeMy WebLinkAboutBUILDING PERMIT 16-1389 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED i 2---7 -I(p
ADDRESS 41 el-- p Le.C(ca Hl.4 A1. .C.
OWNER CONTR.
PHONE NO. PERMIT NO. I L 13W/
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL ,9.°
COMMENTS: el'1 t d.
0 / - - C.,-�.-�' . c.,c
YORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,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
0RecCITY OF PRIOR LAKE BUILDING PERMIT, Date 'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z` �, 6
AND UTILITY CONNECTION PERMIT l
y'1vNe5olP I.White Fay PERMIT NO. X, 436/
2. Pink Cit
3 Yellow Applicant
se type or print and sign at bottom)
DRESS 0,,,,s7f sf ZONING(office use)
(89g
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)OWNEce....
&a-,r11-0S5 (Phone) gS a' ( 0 6 cy
(Address) cav
J
(Co DER c �{�/ •
L d f--S l�C C CK.C)i a-cU O 7 b 7
(Company Name) Pr l , (Phone)
(Contact Name) t-- stA S (Phone
(Address) q07?-- it • OD 177 q0-0
TYPE OF WORK 0 New Construction ❑Deck DPorch Re-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.C.
0 Misc.
Type of Construction: I II III IV V A B4 .
lipanty Group: A B E F H I M R S U PROJECT COST/VALUE S D
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 f use. Furthermore,I hereby agree that the city official or a des nee may enter upon the property to perform needed inspectio s.
, Signature - Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ �� Water Meter Size 5/8"; 1"; $
State Surcharge %(,.1 Pressure Pressure Reducer $
Penalty �oOF O ®� Sewer/Water Connection Fee # $
Plumbing r c�S�VMA`NOAOS OV C' Water Tower Fee # $
Mechanic. Q� Q.t1111)
Sewer
Builder's Deposit $
Sewer&W r��� Other $
Gas Fireplace Vt. $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid /o If- v2) Recei. o. 752-4/
Date /Z _ / (6 By ,c�
Building Official Date
I
,,` y7
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
Planning Director Date Special Conditions,if any