HomeMy WebLinkAboutBUILDING PERMIT 16-1005 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /( i
ADDRESS 156 G.---) j4 pP O _ 't.
OWNER CONTR.
PHONE NO. PERMIT NO. / 16667
❑ 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
)21 FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: I- 3S(.6
,�
Il /� ,
-WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT W , ALL 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
I, •—
� PRlp�
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
(4-
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE l
., z AND UTILITY CONNECTION PERMIT C/y l l 'f'
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I. White File PERMIT NO. ,� G��
�IH1VESp�� 2. Pink City
3 Yellow Applicant J
ase type or print and sign at bottom) ZONING(office use)
ADDRESS
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Phone) �3 _ ��
((Name) AG\5�� A,�'.A g,S ..,.. \\ (t3c 1 (.0�.�1�
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tt..c. k� �
(Address) 0`�C'�"� �p �,Aut,�c.�C�w�� �� f�
BUILDER (Phone) `lSl.`SCO �� 3
(Company Name) (S C_ ria;Ot"S
(Contact Name)
���-1... Qt t..f,S0IN (Phone) 4id=1Q\ 3\C
(Address) ` \ A \\c�, ` i1 S. S�\ k "� ( ts"�' 5 c��N�,�)
��T V� , hlr�'\is
TYPE OF WORK 0 New Construction ['Deck ['Porch We-Roofing j�jRe-Siding ['Lower Level Finish 0 Fireplace
CODE: DI.R.C.
❑Addition ['Alteration ['Utility Connection
Misc.
4iiieu
❑I.B.C. _
e of Constriction: I II III IV V A B PROJECT COST/VALUE $ e�
pancy Group: A B E F H I M R S U (excluding land)
vision: 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 subbmrte dand s.iI apt aware that the building
official can revoke this mit f st cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property perform
tic. \(4i E'(D3 3��t\(v
X
Signature Contractor's License No. Date
Permit Valuation
Park Support Fee # $
$ C C j iJO SAC # $
Permit Fee �j
Plan Check Fee $
Water Meter Size 5/8"; 1"; $
State Surcharge $ J
r W Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $
Builder's Deposit $
Sewer&Water Permit Fee $
Other $
TOTAL DUE ; 1 `,
Gas Fireplace Permit Fee $ $ �/��J�a 7
Receipt No. ' k:' / 7
This Application Becomes Your Building Permit When Approved Paid �)1 By � j
Date 9. I t(jj _
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
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.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372