HomeMy WebLinkAboutBUILDING PERMIT 16-657 DATE TIME
SCHEDULED 1 H .,—
CITY OF PRIOR LAKE INSPECTION NOTICE
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ADDRESS gl \ c",
CONTR. __IL-9
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OWNER
PERMIT NO.
PHONE NO. ❑ �GRpDIFILLING
0 PLUMBING RI 0 COMPLAINT
❑ FOUNDATIONFOOTING 0 MECH RI 0 COMPLAIN
❑ A 0 WATER HOOKUP 0 RI
❑ FRAMING 0 SEWER HOOKUP 0 FIREPLACEREPAIR FINALAL
❑ INSULATIONA0 PLUMBING FINAL
❑ SITEEL 0 MECH FINAL -4..
❑ INSPECTION
COMMENTS: ,
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1111 -41:111
A
.WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Cont
r:
.4.„,(201•2-6"1"5 "__
Inspector:
CALL 4479850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.&NE E
CODE REQUIREMENTS ARE
FOR YOUR PERSONAL HEALTH
IMSNOTI
PRI04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
' TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / 7 ``
AND UTILITY CONNECTION PERMIT , (o
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I-White File /k,. Pink City PERMIT NO. / }-�-3 `�1�✓J3- Yellmv Applicant[ llVll///
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
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LEGAL DESCRIPT(IO�N(office use only) �. 49-- /LOT BLOCK fADDITION 5//�/2/e/' — PrD 2- - /((6 - 0 —0
OWNER(Name) C L ( \AA% (Phone) M1.7 Ci t O `0 I
(Address)
BUILDER l 4 -� �� � -��
(Company Name)`,�! ,A �' i\�` t�" , uill (Phone) �/
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(Contact Name) '�1 1 11JA L I ,,/ (Phone) -IA L (l L__
(Address)1kA �llY X\ q �-k NW t \t 55819_
TYPE OF WORK Q New Construction ODeck DPorch !J Re-Roofing ['Re-Siding []Lower Level Finish 0 Fireplace
['Addition ['Alteration DUttlity Conn: i e i
: DLILC. DLB.C, .'
0 Misc:
of Construction: I II IQ 1V V A B K
(j\
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ � _.
Division: 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 revoke this permit for just cause. Furthermore,I hereby agree that the city official ora designee may enter upon the property to perform needed inspections.
X tttri- 0 C(it,--N0171 L9 ((te ((u
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ 12)
!1 f C Water Meter Size 5/8";1"; $
State Surcharge $ / Pressure Reducer $
Penalty $ ( t N Sewer/Water Connection Fee - # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ /)} Builder's Deposit $
Sewer&Water Permit Fee $ 0 ff r t (l Other $
Fireplace Permit Fee S 1 TOTAL DUE $ /0 c
Gas
This Application Becomes Your Building Permit When Approved ped /1) '(f d
Receipt NO. ✓7Date f L I G.
By ,0 ff
te
Building 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
when 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
issued.
nl.,,,.,:.,.,illre..r„r Date Snecial Conditions if any