HomeMy WebLinkAboutBUILDING PERMIT 16-976 DAT TIME
CIINSPECTIONTY OF PRIOR
NOTICE LAKE SCHEDULED -'
ADDRESS L
OWNER CONTR.
PHONE NO. PERMIT NO. g®7��
0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0❑ FOOTINGMECH RI 0 COMPLAINT❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RICE FINAL
P
RELA
❑ INSULATION 0 SEWER HOOKUP 0❑ FIPLA AIR TSL
❑ FINAL 0 PLUMBING FINAL ``
❑ SITE INSPECTION 0 MECH FINAL
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COMMENTS:
it ORK SATISFACTORY,PROCEED
ri CORRECT ACTION AND PROCEED
0 CORRECT , '-K,CALL FOR REINSPECTION BEFORE COVERING
Op
Inspector.
%..' 0 OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
ration
(OR1,6, •) CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
t( / ! \ ') TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
r/ J. �' AND UTILITY CONNECTION PERMIT g.-. ac,,
�I �e-
N E S O
1.White City
File
2. Pink PERMIT NO. `6 976�
3.Yellow Applicant
e type or print and sign at bottom) ZONING(o4413 Pasa41.- StNrCx--(-- ffice use)
RESS
LEGAL DESS C�IO office use only
LOT BLOCK A 41) TI• , PID
OWNER \ / Z— '`�4fl— g '
(Name) V 4--t Z(A)e.._6<-4/ (Phone)
(Address)
44- Z 3 -P(-ce.:sc,_►.•-4 , c - ✓1`,)✓ L-kc
BUILDER
6-la S (.e� "iv., (Phone) C,2—4i°— 8(09 6
(Company Name) ejl
(Contact Name) c` (Phone) (A 2 4'10-- 81
(Address) 'V 13 iki C wee 3----4,144,‘ jV►l4-(
5S-35"Z►
TYPE OF WORK 0 New Construction ❑Deck ❑Porch We-Roofing ORe-Siding OLower Level Finish 0 Fireplace
❑Addition DAlteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc:
siType of Construction: I II III IV V AB
pancy Group: ABE F HI MR S U PROJECT COST/VALUE $
ion: 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 is permit for just cau � Furthermore,I hereby agree that the city official or designee may the property to perform needed inspections.
- cc z —1W
X Yy�
Signae Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ r SAC # $
Plan Check Fee $ 0 Water Meter Size 5/8"; 1"; $
State Surcharge $
Ile;°.1................-- 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 $ (01/1c. 00
This Application Becomes Your Building Permit When Approved Paid/ o4 l i/v Receipt No. W 1/ 17
Date f
2�/ l +/_, `f 7 By
Building Official Date
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
IIIigned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372