HomeMy WebLinkAboutBUILDING PERMIT 16-1210 DATE TIME
CITY ECTIO
OF PRIORNNOTICE LAKE SCHEDULED L i 24, (co ---
CI NI
ADDRESS 3 a5CQ 0 -70-A l r
OWNER CONTR.
PHONE NO. PERMIT NO. („ —
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOONINGDATION 0 MECH RI 0 COMPLAINT
❑'FRAMING 0 WATER HOOKUP
❑ FOA0 FIREPLACE RI
SEWER HOOKUP 0 FIREPLACE FINAL
❑ INSULATION 0 0 GASLINE AIR TST
0 PLUMBING FINAL
L:l
SITE INSPECTION 0 MECH FINAL 0
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COMMENTS:
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WORK SATISFACTORY,PROCEED
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❑ CORRECT ACTION AND PROCEED
0 CORRE 0- ,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contra
-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
1NSNOTI
DING PERMIT, Date Recd
4—PRI-04b CITY OF PRIOR LAKE BF�01�iING COMPLIANCE /0,/ 9, 7(0
TEMPORARY CERTIFICATE O
!� 1 AND UTILITY CONNECTION PERMIT
r1�44 �1 o AiA\&X'S k �k(\�(\J&
N E s �' , ', PERMIT NO.
White Fie /� i 2.- / O
2. Fink City
3. Yellow Applicant
(Please type or print and situ at bottom)
ADDRESS ZONING(office use)
llL 1 .\ \. i%1 \ ti k \AN �' 1
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
OWNER C ►t A (Phone)
(Name) - \t `� `
(Address)
BUILDER �, �� Cin (Phone) E1 �) � -P
(Company Name) (Phone)
(Contact Name) 111:. sinitis C�
(Address) \\ . r ,IL` t\, A ►l..
% k - , r..'L ��
TYPE OF WORK 0 New Construction CI Deck 0 Porch :1 Re-Roofing ORe-Siding 0 Lower Level Finish 0 Fireplace
°Addition °Alteration DU[iLity Connection
eo:
0 Miss_:
EILR.C. EILB.C.f Construction. I II III IV V AB PROJECT COST/VALUE $ +`� �°r�
Occupancy Croup: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
t I am the
or
horized
t for the
I hereby certify that I and that informationlconstruction will conform to all existing state and local jaws anmy d will proceed in accordance with se true and correct I also certify suubtmitted plans. Imam aware that thenbuiilding
above-mentioned property and that all enter upon the property to perform needed inspections.
permit forjust cause. Furthermore,I hereby agree that the city official or a designee may Po � i
o-.�. can revoke this � 1
eglit
XSI& Signature
Contractor's License No. ate
Signature
I
Park Support Fee # $
Permit Valuation
Permit Feed. SAC # $
_ $
Water Meter Size 5/8'; 1";
Plan Check Fee c 08+� $
Pressure Reducer
State Surcharge , , � e G�_________ Sewer/Water Connection Fee - # $
Penalty , {� P "�Ve1���`� Water Tower Fee # $
MacPlun Qom" 0" Builder's Deposit $
Mecha. �p G� $ $
Other
Sewer r& ��,,��e� -ee $ TOTAL DUE $
Gag pla emit Fee $
This Application Becomes Your Btu'iding Permit When Approved Paid
/� _ f ' Re'ei.t No. /
Date C B Jr_"�' _.
L_ `
BuildingOfficial Date
This 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
when signed by the City Planner constitutes a temporary
Certificate of Zoning compliance and allows construction to commence. Before occupancy.a Certificate of Occupant must be
issued.
nate
Special Conditions_if anv
Dlm...+nn Tl:.nr.n.