HomeMy WebLinkAboutBuildingPermit 11-0321 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 61 511 I
ADDRESS 5y 0 `t w o
OWNER CONTR.
PHONE NO. PERMIT NO. ( ( -- rzl
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
ie—FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS: ?C)0
AI 1
❑ WORK SATISFACTORY, PROCEED
❑ CORRECT A ON AND PROCEED
❑ CORREC WOKE CALL FOR REINSPECTION BEFORE COVERING
a
Inspector Owner /Contr:
CA 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
o P-11-..,../(4 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,=' A'Le
TEMPORARY AND CERTIFICATE
TILITY OF ZONING CONNECTION PERMIT COMPLIANCE 5 a 44 3
T.
M /A'NESoNP I. White File i - -- ^
2. Pink city PERMIT NO. // G
3 Yellow Applicant 1' f
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5 9 / 4-O P4 ST.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /
(Name) _3 0 HOBS // ' (Phone)
(Address)
BUILDER
(Company Name) ` i 71 .f t/ /&v &FiA 9 (Phone) 11-,3 b ¢ --
2
(Contact Name) � / /C4 0 /Z 7� / / (Phone)
(Address) 36, Y Y . zoo7' -f 5T; , v 0 2 A f tl N 3
55 S -
TYPE OF WORK ❑ New Construction ['Deck ❑Porch e- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Alteration ['Utility Con ti
CODE: ❑I.R.C. I.B.C. ❑ ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have fitrnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 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 inspections.
'/ S. Z. /
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ 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 $ 9 75
This Application Becomes Your Building Permit When Approved Paid '7 f, 7.T R ipt No. 41...,.51
Date 571, //
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.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372