HomeMy WebLinkAboutBuilding Permit 16-1163 DATE TIME
CITY OF PRIOR LAKE gCHEDULED I 4/../jk_INSPECTION NOTICE ---
ADDRESS G (
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OWNER CONTR.
PHONE NO. PERMIT NO. ___1(?_ - G(.. ______
❑ 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
j--FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: S}„„o
0(0 _
ArORK SATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
❑ CORRECT W K, ALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Contr:
CALL -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
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CRI0�P CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /0 , /0 , 1(2
J \„ AND UTILITY CONNECTION PERMIT
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NE50
t. White File
2. Pink City PERMIT (+J//NO. //‘3
3.Yellow Applicant
ease type or print and sign at bottom)
DRESS ZONING(office use)
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LEGAL DESCRIPTION(office use only)
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LOT BLOCK ADDITION PID
OWNER g‹....\‘ ,Jc4,--1�1-k (Phone) !� Pa- SS O(Name) l
VIIC� W
(Address) Z60-3 I �:y`'e � � �"
BUILDER
(Company Name) - .7,-.)eN-1 of 14'7k J y 5 C C O --Zr--e__ (Phone)
(Contact Name) 4'r`-1'2 `1 e�K�WS Lam' / I(Phone)/ a t2 66's---7.6 (t
(Address) g .S (( - lz . C te,si z !_4(c-e J-, rJ 3/
TYPE OF WORK ❑New Construc'on ['Deck ❑Porch ❑Re-Roofing DRe-Siding ❑Lower Level Finish ❑Fireplace j
❑Addition teration ❑Utility Connection ✓fes RC:
d- ���1��� GCadNCODE: [JI.R.C. QLB.C. ❑Misc: 72d�G va `
Type of Construction: I II IIIIV V ABlpancy Group: A B E F H I M R S U PT COST/VALUE $ J vim'
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sion: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on is 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 constru on ,ill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
offi revoke this permit . '.. cause. %4 I ore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspe''ions.
X ate
� - Contractor's License No.
Signature
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 $ /O4-, 0 D
This Application Becomes Your Building Permit When Approved Paid /0 1- ail Rece'�t,TC?01 6/
Date /t.). i U, / (a By /�//j'�
Building Official Date
o 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
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gned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372