HomeMy WebLinkAboutBUILDING PERMIT 16-935 CITY OF PRIOR LAKE DA E TIME
SCHEDULED ` ----
INSPECTION NOTICE
ADDRESS 0
CONTR.
OWNER
PERMIT NO. !l t 6
PHONE NO.
0 PLUMBING RI CIEXIGRADIFILLING
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FOUNDATION 0 FIREPLACE RI
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE FINAL
❑ INSULATION 0 SEWER HOOKUP ❑ IREPLA AIR TST
FINAL 0 PLUMBING FINAL ❑
❑ SITE INSPECTION
0 MECH FINAL
COMMENTS: 14) . 0
$ WAWA
WORK SATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
O CORRECT WO' ,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr.
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURSIN &V ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH
IfSNOTI
oc PRia; CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
�4NESO�" I. White File PERMIT NO. ����`-, �j
"'
2. Pink City /G, 7
3 Yellow Applicant ✓
type or print and sign at bottom)
ItalpeRESS ZONING(office use)
/ 5037 8/ace Dal' Road l(/
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
Name / '! / chat ! /J o u t ( (Phone) q c2/4/17. r 5V/(Address) /5. 0 3 7 B [ a c4 0 Q te ed NE
T_
BUILDER Pella Northland
(Company Name)_ (Phone)
15300 25th Ave N. Ste 100
(Contact Name) Plymouth, MN 55447 (Phone)
(Address) Lie#BC645090 Ph. 763/745-1400
TYPE OF WORK ❑New Construction ['Deck ❑Porch ORe-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace 1
❑Addition ❑Alteration ❑Utility Connection 5 e,,,J7 f j /t Pl4 LL /r? #41'f
CODE: ❑I.R.C. ❑LB.C. ❑Misc. Q X/7 /ill ` Op Q /�QZnp�'
(excluding land) r
e of Construction: I II III IV V A B PROJECT COST/VALUE /$ 9 D 5
41 .11
panty Group: A B E F H I M R S U
vision: 1 2 3 4 5
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 inspe lions.
'')civ^ 6C 6 � 5' oQo fits
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee i $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ 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 $ i OLf (�
This Application Becomes Your Building Permit When Approved Paid yt-k „.0 Rece t No. (i 63 1Date � 40 By
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
. cd.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake.MN 55372