HomeMy WebLinkAboutBuilding Permit #13-1296 C�TY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED �- �
ADDRESS 1 �, I � �
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OWNER CONTR.
PHONE NO. PERMIT NO. i� � 1 2�
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O FOOTING O PLUMBING RI
❑ FOUNDATION O MECH RI � �G�D�ILLING
❑ FRAMING ❑ WATER HOOKUP � COMPLAINT
❑ INSULATION O SEWER HOOKUP � F�REPLACE RI
❑ FINAL ❑ PLUMBING FINAL � F �� P �CE FINAL
❑ SITE INSPECTION O MECH FINAL ��SLINE AIR TST
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COMMENTS:
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�WORK SATISFACTORY, PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. � p�er/Contr.
CALL 447.gg50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH �c SAFETY!
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�, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" � " AND UTILITY CONNECTION PERMIT
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� ,� r .� . � 1. White File
;' _ 2. R� �;�. PERMIT NO. I�
. 3. Yellow Applicant
ease or ' t and si at bottom
ADDRESS ZONING (o�ce use)
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LEGAL DESCRIPTION (office use oniy)
LOT BLOCK ADDITION PID
OWNER f
(Name) (J ` I e (Phone)
cAd�ss, 1 � � � � _ � ,
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BUII.DER / -f�S � Z � 7� S� 0 f�
(Company Name) l� P�S fiCOI/tZ'f"1(7//1 '�� CJ� (Phone)
(Contact Name) �(['� �� � ��O c �,0! � (Phone) 7l �� �S 7� C� C7 "7' �
(Address) � � (� � � e� UJ'
TYPE OF WORK ❑ New Construction �Deck ❑Porch �Re-Roofing ❑Re-Siding �Lower Level Finish ❑ Fireplace
�Addition ❑Alteration DUtility Connection `
CODE: DI.R.G ❑I.B.C. ❑Misc: � a � -5 `w G��
Type of Construckion: I II IQ IV V A B D Q Q
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE S —
Division: 1 2 3 4 5 (excluding land)
I hereby cettify that I have fumished information on this application which is w the best of my lmowledge true and coirect. I also certify that I am the owner or authorized agent for the
above-mentioned pr rty and that all constructio Il orm to alhe�dsting state and local laws and will pmceed in accordance with submitted plans. I am aware that the building
oRicial can revo �s perrnit for just cause � ereby that the city otEeial or a designee may enter upon the pmperty to perform needed insp ons.
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Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surchazge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Percnit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ � 7
This Application Becomes Your Building Permit When Approved Paid Rece' N. .
Date B �
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Buildin 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. T'his document
when signed by the City Planner consritutes a temporary Certificate of Zoning compliance and allows construction to commrnce. 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 (9S2) 447-4245
4646 Dakota Street S.E., Pdor Lake, Minnesota 55372 �! �
l' Ir 75
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