HomeMy WebLinkAboutBUILDING PERMIT 16-1396 DATE TIME
CITY OF PRIOR LAKE SCHEDULED j 4 —
INSPECTION NOTICE
ADDRESS _ 9 5g .M
t ,.._ !!)OWNER CONTR. 0'
PHONE NO. /
PERMIT NO. " - 7- L & —
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION
• FOONINGDATION p 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 INSPECTION 0 MECH FINAL
COMMENTS:
A.
1111M1 i
%ORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
If
n
Inspector: I Ower/Contra
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
PR�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
! 9 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v I )t AND UTILITY CONNECTION PERMITI
lQ � 'LLD
err ose
NN E s 1. White File
2. Pink City PERMIT NO. l b— 13)1(00
3. Yellow Applicant
e e or 'lit and sign at bottom)KESS . ZONING(office use)
°15c6 S .(in SW C
LEGAL DESCRIPTION(office use only) • L3,3 f !�V`�t5' ( Q
L,����� 1 r 00, r , j C UA.ICrl JLiC?t-� PID
'��BLOCI�"QADDITION
OWNER (Phone) QSZ 2
(Name) Ul GDS LU Y\Ok'1?-5rc),ctfz
(Address)
BUILDER (Phone)
(Company Name)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ['Deck [Porch Re-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace
❑Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C.Construction: I.B.C. ❑Misc:
T e of I II III IV V A B PROJECT COST/VALUE $
pancy Group: ABE F HI MR S U (excluding land)
ion: 1 2 3 4 5
I hereby of my
owledge true and
above-mentionthat I ed propearty and furnished
th t all constructionation nthis application which is to the will conform to all existing state and local laws and will proceed incorrect.
accordance wcertify
ith submittedl plans.owner
I am aware that the building
official can r ,iiithis permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.spections.
1%4 /
% V - jw�oSignatureure dr Contractor's License No. Date
Permit Valuation
Park Support Fee # $
$
lfL�/� SAC # $
Permit Fee
Water Meter Size 5/8"; 1";
$
Plan Check Fee $ $
State Surcharge $ i 0
3 Pressure Reducer
Penalty $ ` Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $$
Mechanical Permit Fee $ Builder's Deposit
Sewer&Water Permit Fee $ Other $$ I O(4_,C10
Gas Fireplace Permit Fee $ TOTAL DUE ,``���
` w Receipt No.
This Application Becomes Your Building Permit When Approved Paid 1 �^ I Re S I
Date 0--. J s( C
Building Official Date
ance and may preed as
to certify that the request in the above le
Planner constitutes a temporary Certificate of Zoning on and accompanying ocompliance and callows construction to commence. Before occupancy,a requested.
Certificate must be
igned by the C ty
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