HomeMy WebLinkAboutBuilding Permit 11-0116 DAT TIME
C(TY OF PRtOR LAKE
INSPECTION NOTICE SCH ULED � �S /I �
ADDRESS � O� � Zd� 1
OWNER CONTR.
PHONE NO. PERMIT NO. l� [!�
❑ FOOTING � PLUMBING Ri ❑ EX/GRAD/FILUNG
❑ FOUNDATION O MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULA710N ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
�5(, FINAL � PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI ' O
�
COMMENTS: Lp,� w �
S��- ,� �',��9�
WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION ND PROCEED
❑ CORRECT K LL FOR REINSPECTION BEFORE COVERING
inspector: ontr:
CALL 447-9850 EXT iNSPECTtON 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
ws�v�on
��� PRIp�
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� D� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v
AND UTILITY CONNECTION PERMIT Z� 2 �' `
�
j NN E S��
1. White File pERMIT NO . � ��
2 Pmlc City
3 Yellow Applicant t �
ease or ' and si at bottom
ADDRESS ZONING (ot�ce use)
�� 350 �oc 12�� �Tca' s� Pr��� Lal�e t�tJ 553� 2
LEGAL DESCRIPTTON (office use only)
LOT BLOCK ADDTTION PID
OWNER 1 ,1
(Name) C UG,QA�1dA �1 Vq IIA (Phone) �5 2 • �ly . �83 2'
(Address)
BUII.,DER ` �" q�
(CompanyName) G►tfIS��GpS� 5/1�- (Phone) 'JZ.�O,2�0�
(ContactName) �1T ���� (Phone) g�2�y o�4��
(Address) Iy�O S�►�N �OQ� C� sp2(� M N J53 �1
TYPE OF WORK ❑ New Consnuction �Deck OPorch ORe-Roofing �Re-Siding �Lower Level Finish ❑ Fireplace
�Addidon ❑Alteradon �Utility Connection
CODE: ❑I.R.C. �I.B.C. �J Misc; �eS �e'� 1!� t v� V I�Mpt G
Type of Constnudon: I II III IV V A B �
Occupancy Group: A B E F H I M R S U PROJECT COST/VALiJE $��� Z.��
Division: 1 2 3 4 5 (ezcluding land)
I hereby certify that I have fiunished infoxmadon on t6is application which is to the best of my ]rnowiedge uve and coned. I also certify that I am the owner or authorized agent for the
above-mendoned property and that all construction will conform to all existing state and local laws and will proceed in accordance wizh submitted plans. I am awaze that the building
official can revoke this permit for jnst cause. Fufthermore, I hereby agee t6at the city official or a designee may enter upon the property to perform needed inspections.
g ��\� � "' _�\
Signature Contractor's License No. Date
Permit Valuation a�� . v O Park Support Fee # $�" �
Permit Fee $ '"l S� SAC # $
Plan Check Fee $ C� Water Meter Size 5/8"; 1"; $
State Surcharge $ ` � V C7 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanica.l Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applicallon Bewmes Yoia Building Permit When Apptoved Paid Z. �C ei t NO.
Date Z ,
Buil ' official Date
T6is is to certify that the reqnest in the above application and accompanying documents is in accardance wiW 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.
Planning Director Date Specisl Conditions, if a�ry
24 hour notice for all inspections (952) 447-9850, faz (952) 447-4245
4646 Dskots Street S.E., Prior Lake, Minnesota 55372