HomeMy WebLinkAboutBUILDING PERMIT 16-617 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS 1 4 a U t),„, Q l
OWNER CONTR.
PHONE NO. PERMIT NO. /lj— (17
❑ 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 FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: W; ,5
`ito5e. 4/4_
c
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT ,CALL 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
of nu% CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
. ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /' IL,
NI AND UTILITY CONNECTION PERMIT lit 1S(�'
kilpfxEsos' I. While File PERMIT NO. j 6 fp 11
2. Pink City ! 1'
3 Yellow Applicant
type or print and sign at bottom)
DRESS ZONING(office use)
14288 Dove, Caulk IJE ,TYigr 1Ar_c4 Mk) cs33 2
LEGAL DESCRIPTION(office use only)
F
0.-
LOT( BLOCK I ADDITION KAA9 6, 5- 4-d,J PID =3 -,6/0---(9
OWNER , �n 61 52" yo -(o1{Z1
(Name) ,"�l.(K A Q ''1C t, (Phone) . � —
(Address)1425?) POVe CD0e4 NZ. 1 1 caw lkka,MN ,S3'72
BUILDER �(
(Company Name) 1 k I c __ (Phone) (" 1- SS -2101
(Contact Name) V-vOVl,,4c /„) (Phone)
(Address) 361O0 totieJe A4 Z4 1( kt k 25 1 cS't'CLotxA}W!� (o''ok
TYPE OF WORK 0 New Construction ['Deck ❑Porch ORe-Roofing ❑Re-Sidi ❑Lower Level Finish ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection / C_%(
CODE: ❑I.R.C. .B.C. 0 Misc. k)D1 '3 `4 1 �'�►�1 "" " 0
of Construction: I II III IV V A B PROJECT COST/VALUE $ A'23 i o 1
pancy Group: ❑IA B E F H I M R S U (excluding land)
ision: 1 2 3 4 5
1 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 inspections.
xC.c0(o�ld5 to-1' O
Signature Contractor's License No. Date
__Oppp0
Permit Valuation Park Support Fee # $
Permit Fee $ + 09 SAC # $
Plan Check Fee $ v t� Water Meter Size 5/8"; I"; $
State Surcharge $ t, ' Pressure Reducer $
Penalty $ „ Sewer/Water Connection Fee # $
PIumbing Permit Fee $ ` Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $ (�}� \
Gas Fireplace Permit Fee $ TOTAL DUE $ j C ` c V"'1
This Application Becomes Your Building Permit When Approved Paid W IA .(00 Receipt No. l(2'7
Datef o �� ByZ.:\'ffp..e5
Building Official Date ,1))
liis 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
rr signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certi icate of Occupancy must be
•
lied.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372