HomeMy WebLinkAboutBUILDING PERMIT 16-0836 DATE TIME
CITY OF PRIOR LAKE J2iJ
INSPECTION NOTICE SCHEDULED ((0
ADDRESS I L(r-1 ( 0 L
OWNER CONTR.
PHONE NO. PERMIT NO. lCe - b 3
❑ FOOTING 0 PLUMBING RI ❑ 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 FINALnn '' ❑
COMMENTS: Lk); ‘AAcub. V�e��c.J7
yI WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRE •K,CALL FOR REINSPECTION BEFORE COVERING
inspecto � ' Owner/Contra
CAL!447' 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
OF PR I0�P �l \U`l U u
1 '7 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
i I \ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
"" L t-z' AND UTILITY CONNECTION PERMIT
- ,./7: ..70 ,.., y
so
1.White File PERMIT NO.
2. Pink City /6
3.Yellow Applicant
ase type or print and sign at bottom)
flik
DRESS \t.,�11(J Lt�K\ste, v_Avs\e ZONING(office use)
?c oC \ci•e__. MC\ 5S3\�.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) `-`G.l \V\c : c`i‘(7\e-c (Phone) `ASA-L11/4-t0` 5 LVA t
(Address) LL-\-\10 Cc&t\ec \c fe Qc'koc \' t'n 'R. SS-SA' ,
BUILDER
(Company Name) c c s. F x v ncs (Phone) c'tSa-- 'Ss--1- 1613
(Contact Name)V .,,. c o cU'- (Phone)
(Address) 5(.)\"'‘. ,n: c.f.A\.e-\ clue S f--, c,-nk t ltUR M'c\ SSt-1a.0
TYPE OF WORK ❑New Construction ODeck Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ['Utility Connection
CODE: D.R.C. ❑LB.C. �Misc: U.7�ClJ tp Q�GtG�`RE n�
vi
Type of Construction: I H III IV V AB
c •.
ccupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ SSS tO
'sion: 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 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 far ju use rthermore,I hereby agree that the city official ora designee may enter upon the property to perform needed inspections.
x /�ilia.. (DC-00(o�hL-( - \�—��
Crre Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ eL 0 Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ �O C) 3 Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other Sp 62)
Gas Fireplace Permit Fee $ TOTAL DUE I `
This Application Becomes Your Building Permit When Approved Paid �014 ,Ob Receipt No.
J s
Date By
. :„5Building Official 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
n 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
I ___ Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372