HomeMy WebLinkAboutBUILDING PERMIT 16-1097 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 1/ / /,' .,
7
ADDRESS /
S �( ►'1 c^-
OWNER CONTR. /
PHONE NO. PERMIT NO. / 6
❑ 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 INSPECTION 0 MECH FINAL scEr
COMMENTS:
C - - 7 •
'WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WO 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
4bPRIO*c
CITOF PRIOR LAKE BUILDING PERMIT,LIANCE Date Recd
TEMPORARY CERTIFICATE OF ZONING COMP
x AND UTILITY CONNECTION PERMIT
v
��NNEso��, . White File
2. Pink City PERMIT NO. /6, _ ( G 17 71
3 Yellow Applicant
type or print and sign at bottom) I ZONING(office use)
DRESS 5 ) 5 5 W Yj .�- CA—, v
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ( �`
(Name) l. e C-'.e- \ t (X, 17006rer
(Phone) UL I 0 ' l`w - CD 7 D-
(Address)
..tBUILDER A'\a�(5-e.NJ (Phone) (051 -a�i-y 0 gB
(Company Name) InC v.X�\ ��
(Contact Name) (Phone)
`(Address) 19 20 CD• "?.,8. "C" We53r '?C®�2vi1‘f 1 \-"c\c\..) SS II-2,
TYPE OF WORK ❑New Construction Deck Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
Addition DAlteration ❑Utility Connection
's1^Q
CODE: ❑I.R.C. ❑I `l 12 �"/ 64:21^O'�
iiiie of Construction: I II III IV V A B PROJECT COST/VALUE $ J ✓
pancy Group: A B E F H I MR SU (excluding land)
sion:
1 2 3 4 5 IAD:r1 ,-14
I hereby cenify th t,t have himished 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 .r•perry and that all•L
•struction 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 is permit for Justurthermore,I hereby agree that the city official or a designee may enter upon the property to perfor/ .edcd inspections.
0 41 �uGlogsa3 - ate
X
Signature Contractors License No.
Permit Valuation Park Support Fee # I $
Permit Fee $ I SAC # $
Plan Check Fee I $ 1 ( Water Meter Size 5/8"; 1";
Pressure Reducer $
State Surcharge $ I
Penalty $ Sewer/Water Connection Fee # $ ,
Plumbing Permit Fee I $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee i $ Other
Gas Fireplace Permit Fee i $ TOTAL DUE $
This Application Becomes Your Building Permit When ApprovedI Paid 01-1, Re ei t No.
Date Ci 9-I-P- ; B
Building Official Date
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 I
IIIsigned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
d
Planning Director Date Special Conditions,if any