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BUILDING PERMIT 16-1276
DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 1 1 ' 14 ADDRESSJ OWNERCONTR. PHONE NO. PERMIT NO. L.126:_rial___-(4 0 PLUMBING RI 0 EX/GRAD/FILLING ❑ FOONINGDATION 0 MECH RI 0 COMPLAINT ❑ FRAMING 0 WATER HOOKUP ❑ FOA0 FIREPLACE RI ❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL ❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST ❑ SITE INSPECTION 0 MECH FINAL V -Ob`-A �e-P COMMENTS: r - - 4+WORK SATISFACTORY,PROCEED O CORRECT ACTION AND PROCEED ❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING Inspector: --GOwner/Contr: nspector: Owner/Contra ______________.aet. --- CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY! INSNOTI 9007 —4'4/7. Oar of PRtO� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / /. 1.,/ (0 r I AND UTILITY CONNECTION PERMIT ktiv,„50s'' I. White File 2. Pink City PERMIT NO. /jame� /(2,.7 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS s� fo c22/J ZONING(office user 5g�6 �, D# /' 3-_s-5 7 2— LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (pT9 ,F 4 /32, 7 (Phone) 9t a....,?a6 - v5-,5Z) (Address) j-15/_.5 /57M a s6<-44i: Ad b-5-37 4.1- BUILDER I� (Company Name dia �� € / /fj�( (Phone)AV^ 7_a/7a/ nAg' (Contact Nam.,_ ,v 4C':ft - 04-9 U (Phone)/' X x.5'5S7 ,�7o/ pt" /6 J (Address) 4 2 .„, ,,,,),,,e,,,,,/ 4 /d r 4„,,,, iVi 4©3 01 TYPE OF WORK 0 New Construction ['Deck ❑Porch ORe-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace 0 ❑Addition ['Alteration ❑Utility Connection bvP Irl/ �J CODE: ❑I.R.C.ilioL., ❑I.B.C. ❑Misc. ,�l/f ype of Construction: I II III 3 V A B PROJECT COST/VALUE $ T/�� °Occupancy Group: A B E F H I M R S U (excluding land) Division: 1 2 3 4 5 I hereby certify that I have furnished 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 officio .n rev.ke this permitfor jus ca e. urthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X �2�t. ee / i frC- 66 o 0636 /6-/,-076/ / Signature Contractor's License No. Date Permit Valuation 2 ,60_00 Park Support Fee # $ Permit Fee $ /03 y 0 0 SAC # $ Plan Check Fee $ . — Water Meter Size 5/8"; I"; $ State Surcharge $ /, U U Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ j Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $/D ae s This Application Becomes Your Building Permit When Approved Paid /©44. 0 6 Recei t No. 148/Date / 21 i4' By �� 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 ssucd. Planning Director Date Special Conditions,if any I 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372