HomeMy WebLinkAboutBUILDING PERMIT 16-700 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED ZZ
ADDRESS / 76 6d' L Q't ✓ ra k
OWNER CONTR.
PHONE NO. PERMIT NO. IL , `10 U
❑ 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 4(
COMMENTS:
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT K,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!
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,i PRIO
A� %�'.N 7,,.. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
c'7 / ` \� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
U' , \y`� AND UTILITY CONNECTION PERMIT (10 (n
�fNN E S�`S.e c Z,11,�Y
I. white File
2. Pink City go,-(1701PERMIT NO.
3. Yellow Applicant
type or print and sign at bottom)
1111
RESS ZO Goffice use)
t(o arecit4- 12-ukr [2-4 sE-
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID &�S^' 'C(C 'C
OWNER --D i
(Name) im r- � o 1�, VSO. 1� (Phone)
✓
(Address) L� ! l CJ' P` 1, g 4.)
BUILDER - e Iii,
(Company Name) 1 it.:.._ l _ (Phone) SD.. ..--7-70-7 q) I
(Contact Name) R��.� - ,, 2r (Phone)
(Address) ) S 6 -7 is C, iti,,,P ,
TYPE OF WORK 0 New Construction ❑Dec ❑Porch e-Roofing ORe-Siding ['Lower Level Finish
❑Additon ['Alteration ❑Utility Connection ❑Fireplace
CODE: ❑I.R.C.
❑I.B.C.i
0 Misc:
T pe of Construction:iipi
I II III IV V AB
ancy Group: A B E F H I M R S U PROJECT COST/VALUE $
on: 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 cont. to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can re s,e this.-rmit for just cause. Furthermore,I - -,y agree that the city official or a designee may enter upon the property to perform needed inspections.
t —g.ignature IP- Contractor's License hl o. Date
Permit Valuation 65-
Park Support Fee # $
Permit Fee $ I SAC # $
Plan Check Fee $ (' Water Meter Size 5/8"; 1"; $
State Surcharge $ 100 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 $ lo(x.
��
This Application Becomes Your Building Permit When Approved Paid h)rtr3,,
Receipt No JDate 0iVT By
Building Official Date
leto 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
gned 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