HomeMy WebLinkAboutBUILDING PERMIT 16-1109 DATE TIME
CINTYSPECTION OF PRIOR NOTICE LAKE SCHEDULED C
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OWNER PERMIT NO. G! (t
❑ EXIGRApIFILLING
PHONE NO. 0 PLUMBING RI ❑ COMPLAINT
RI
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0 MECH RI 0 FIREPLACE FINAL
❑ FOOTING ❑ WATER HOOKUP ❑ FIREPLACE 13
p FOUNDATION
ION ❑ SEWER HOOKUP 0 GASLINE AIR TSL
TION ❑ PLUMBING FINAL ❑
❑ INSULA 0 MECH FINAL
FINAL
❑ SITE INSPECTION
COMMENTS: r d,
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0 .._, Waled
WORK
SATISFACTORY,PROCEED
PROCEED
0 COR COVERING
Inspector:
❑ CORRECT AC ION AND
RE WOR �CA FOR REINSPECTION BEFORE
pwnerlContr: ADVANCE.
24 HOURS IN A
CALL 447-9850 FOR INSPECTION THE NEXT HEALTH&SAFETY!
ARE FOR YOUR PERSONAL
CODE REQUIREMENT'S ,NSNor,
o� P R l�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
ti / COMPLIANCE
/ TEMPORARY CERTIFICATE OF ZONING 9 Z 7,/0
"(l -[ \ ' AND UTILITY CONNECTION PERMIT
�NESO
1.While File
2. Pink City PERMIT NO. � //C 7
3.Yellow Applicant
e type or print and sign at bottom)
RESS ZONING(office use)
37;1\ ‘i\ --r S1 a n1 V;� C.:r \
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER G� \. (�
(Name) 1 r' a,tT (Phone)
(Address) -3U C\ 1- $l l �(,N4 N , Q^lv 1 v' 0\1
(Comp(Company Name) -n"k fat,‘,,'"t GlD 4- J...141 t 0 k-eng-u-•'e-41 (Phone) 1. 1)3^1&10 --- al a
(Contact Name) j'( \tw r It iii' (Phone)
1-M%1`)
(Address) 1�') N I`` Y'u - C..\,,i.2., 1 v1/..;,,,,),,,,„„3„ l\
TYPE OF WORK ❑New Construction ❑Deck ❑Porch f-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc:
Type of Construction: I II III IV V A B
pancy Group: ABE F HI MR SU PROJECT COST/VALUE $ a to 'n.(•
.ion: 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 pr erty and that all construction will conform to all existing state and local laws and will proceed m accordance with submitted plans. I am aware that the building
official can revoke ermit for just c . Furthermore,I hereby agree that the city official or designee may enter upon the property to perform needed inspections.
X
c (3.\ `03 eA1facNIb
Signature Contractor's License No. Date
Permit Valuation '- SZZ 7 Park Support Fee # $
Permit Fee $ l c;1 zits SAC # $
Plan Check Fee $ •— Water Meter Size 5/8"; 1"; $
State Surcharge $ eva) 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 $ /ULf e./
This Application Becomes Your Building Permit When Approved Paid `d4—v 2') Receipt N,9. j 9,(1/
Date C%1-7-66 By /64 34.1,
Building Official Date
Opto 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