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BUILDING PERMIT 15-0380
DATE TIME CITY PRIOR LAKE �1 INSPECTIONOF NOTICE SCHEDULED ADDRESS OWNER CONTR. ?( PHONE NO. PERMIT NO. f S - J8 ir,�' ❑ 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 FINALASLINE AIR TST ❑ SITE INSPECTION 0 MECH FINAL COMMENTS: SA "WORK SATISFACTORY,PROCEED ❑ CORRECT ACTION AND PROCEED ❑ CORRE - ORKK,CALL FOR REINSPECTION BEFORE COVERING Inspe 122J-5—' Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY. INSNOTI o f PRjo� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,...) ,, .:` • TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4 zip K E AND UTILITY CONNECTION PERMIT l , ,,,,,, , .. , , , , �'/N ,O�e I White File PERMIT NO. l� r (-��' / NES 2. Pink City i Yellow Applicant se type orrint and sign at bottom) DRES, ZONING(office use) 4.39' �A y-srA `e€* LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID CCF (Jt P LpWNE _,C�1 t•.S (Names I' ,©Y1r1Q.Yl S (Phone) (Address) BUILDER '1 ame) S (Phone) (Contact Name) (Phone) (Address) r TYPE OF WORK ❑New Construction ['Deck DPorch DRe-Roofing (]Ilte-Siding ❑Lower Level Finish ❑Fireplace ❑Addition ['Alteration ❑Utility Connection CODE: ❑I.R.C. ❑I.B.C. e of Construction: I II III IV V A B PROJECT COST/VALUE $ panty Group: ABE F HI MR SU (excluding land) ision: 1 2 3 4 5 ❑Misc. 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 submitted plans. I am aware that the building official can revoke this permit for Just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspect() s. s. X ) �c _ V�r/ .�/ Signature Contractor's License No. ate Permit Valuation CPark Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ _,,,.00 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 Gas Fireplace Permit Fee $ TOTAL DUE $11 This Application Becomes Your Building Permit When Approved Paid . 1S— Receipt No.m,fl /1// 1// lDate t 27/ lc- F--By cav"_" Building Official Date s 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 .,ted. Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372