HomeMy WebLinkAboutBuilding Permit 16-1265 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I(/3 16
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ADDRESS 4 Hk
(1?-l.SC-jg, ,
OWNER CONTR. ""
PHONE NO. PERMIT NO. /( ' — l Z LP C)--
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❑ 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
741-FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: tcQ
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WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
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❑ CORR • WO; • •LL FOR REINSPECTION BEFORE COVERING
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Inspect. : ./ Owner/Contr:
CA 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
(0C PlikiCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
4'NHEsott‘ I. White File
z. rick city PERMIT NO. rit . Z(,
3 Yellow Applicant f
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
.A800 14e bice iqd. Ni-j
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LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER y�
(Name) DA vG et 501 AI 14.44 'I (Phone)
(Address) 2f3(X, 1-1At,.rk I4id .a. Al.N;,J
BUILDER Q
(Company Name) IF 1 O Tin e t fnke' (Phone) Qea- 41)7-766'5
(Contact Name) Ali4z. k 14-6>^I k (Phone) 3-2- 9 9,/-39go
(Address) 6ig0 WAhle Dr. (r ,l ke MN 5-75'3 7
TYPE OF WORK ❑New Construction ❑Deck ❑Porch DRe-Roofing fRe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition DAlteration ❑Utility Connection
iiCODE: ❑I.R.C. ❑I.B.C. 0 Misc.
ype of Construction: I II III IV V AB PROJECT COST/VALUE $ d b� �a®Q
ccupancy Group: A B E F H I M R S U (excluding land)
ivision: 1 2 3 4 5
I hereby certify that I have hrmished information on this 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 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 caul Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspc ions.
,,,,,,_,-00
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 $ /0 5/0 0
This Application Becomes Your Building Permit When Approved Paid‘11P q j- Receipt No.a4'e-a` i
Date \ - t\c,. By -1.71-----
Building
7L_
Building Official Date
his 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
hen 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
sued.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372