HomeMy WebLinkAboutBUILDING PERMIT 14-1298 CITY OF PRIOR LAKE DATE TIME
INSPECTION NOTICE SCHEDULED le2g/ia
ADDRESS �j C t' c)Ok
OWNER CONTR.
PHONE NO. PERMIT NO. /CI —I a l
❑ 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 ❑
COMMENTS: Qa_ra. ii,)6 1 letC reCts.e
Clo5-e-
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT '•-, ,CALL FOR REINSPECTION BEFORE COVERING
Inspector. A`� 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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Ari.... PR./. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
A. edib TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
x AND UTILITY CONNECTION PERMIT
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�4'NESO�� I. White File
2
ID
Pink City PERMIT NO. 14 ,. IZo�
3 Yellow Applicant
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ase type or print and sign at bottom)
F
DRESS ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ,I/ •
(Name) Att`I(L^. 5-(75 ik--:-k .C> (Phone).
(Address) V tic.—
BUILDER
(Company Name) ,4--10..r— (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK El New Constr ion ❑Deck ['Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish El Fireplace
❑Addition Alteration ❑Utility Connection /fJ .r /// /
iiityCODE: .R.C. ❑I.B.C. ❑Misc. \ J4�+�C,` `W ` '
pe of C nstruction: I II HI IV V A B PROJECT COST/VALUE $
ccupanc Group: A B E F H I M R S U (excluding land)
ivision: 1 2 3 4 5
I hereby certi thatave hir shed in n ma ion on i is app cation which is to the best of my knowledge true and correct. I also certify that I am the owne.or authorized agent for the
above-mention\ .t•-ty .•,.f that all ns uction ,ill con'.rm to all existing state and local laws and will proceed in accordance with submitted plans. am aware at the building
official can revo,hi'. •••it or Just cast Fort . ore,I4•reby agree that the city official or a designee may enter upon the property to perform needed t pections.
x ' A
Signature Contractor's License No. Da'-
Permit Valuationt"—,tri ZS—J Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ R ` 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 $
This Appli tBeco'i s Your P:nilding Permit
't When A prove t Paid 41,26.-1ReCe1F o.
Date /Z...2.--,14916-7,/
By
L,141A c r . iiv. +—
Built 1-,(fit'law
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
11,
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