HomeMy WebLinkAboutBuilding Permit 16-1224 DATE TIME
CPRIOR LAKE L L3 V=-• ``)
INSPECTION
ITYOF NOTICE SCHEDULED
u ItAidtt .
ADDRESS r 1 i t 0 c/
OWNER
CONTR.
I� IZ�W -
0 PLUMBING RI ❑ EX/GRAD/FILLING
PERMIT NO.
PHONE NO.
❑ FOOTING 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP
❑ FOUNDATION 0 FIREPLACE RI 0 FIREPLACE FINAL
p INSULATION 0 SEWER HOOKUPGASLINE AIR TST
❑ FINAL 0 PLUMBING FINAL
0 MECH FINAL ,.� ----.4.s
O SITE INSPECTION .f c�
COMMENTS:
L
CA S-2-, 9 - -rn.
AL9eWORK SATISFACTORY,PROCEED
0 CORRECT ACTION AND PROCEED
____a-----_
0 CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Owner/Contra
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN
&SAFETY!CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH
INSNOTI
of Pit CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
( TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
4 x AND UTILITY CONNECTION PERMIT
4�NHESes:
0 . White File
2. Pink Pity PERMIT NO. /6 , /2_24--
3 Yellow Applicant
ase type or print and sign at bottom)
DRESS 1 ZONING(office use)
S918 oc8 I c.w(- ) C% cc k 5E,
LEGAL DESCRIPTION(office use only)
I
LOT BLOCK ADDITION PID j
OWNERC� �j
(Name) D'o �h 0 Iry (Phone) / 5 � -51V' it✓
(Address)
BUILDER
(Company Name) rn-Gwc \ "$v, Ckrtdf.(5-e.r (Phone) (051 -a LcL -Li 0'SE
(Contact Name) (Phone)
(Address) 19 2 0 co. -?,c • "G`` u1/4.). 5.1i- •)h05.e v'.,\1-E I \-N1 c\3 S 5 i
TYPE OF WORK ❑New Construction Deck Porch ❑Re-Roofing ❑Re-Sidin ❑Lower Lev 1 Finish ❑Firepl,ace
Addition DAlteration ❑Utility Connection `OLC� LQ U„r OLA-IS LA...)).
❑I.B.C. CI isc. °♦ ' a ►� LP ' _ —q.......
CODE: ❑LR.C. I •
/ 5�(CI Op
Type of Construction: I II III IV V A B J
cupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ /
'ision: 1 2 3 4 5
(excluding land)
I hereby ce fy 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 men ned property and that .. nstruction 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 evoke t permit for Iu•t cau . Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspectit s.
x i �1. '� MO �G�983 ' q0_______/Co
Signature Contractor's License No. Date
Permit Valuation j Park Support Fee # $
l l
Permit Fee $ SAC # $
n
Plan Check Fee $ IWater Meter Size 5/8"; 1"; 1 $
State Surcharge $ Pressure Reducer $
Penalty $ ' Sewer/Water Connection Fee # $ I
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee S Other i $
Gas Fireplace Permit Fee $ TOTAL DUE $
� l
This Application Becomes Your Building Permit When Approved Paid �� fZeCel No. J�
Date �U co.mmence. Before
P,�' f BY
Buildintt Official Date
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 1
wit signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to occupancy,a Ccrttticatc•of Occupancy must be
W
Il
I
j Planning Director Date Special Conditions,if any