HomeMy WebLinkAboutBUILDING PERMIT 16-1223 DATE TIME
CITY OF PRIOR LAKE Z�'�_
INSPECTION NOTICE SCHEDULED
ADDRESS 6 J / i G .. +
OWNER CONTR.
PHONE NO. PERMIT NO. j Cp.
❑ 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 '',I4-
`�,✓I
W
COMMENTS: ST7Cb
/5 ) ---1-1) CA-kr")).------\
WORK SATISFACTORY,PROCEED
CORRECT ACTION AND PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY.
INSNOTI
0of pxta�P CITY TEMPORARY OF
CERTIFICATE PRIOR LAKE BUILDINGOFZONING PERMITPERMIT ,COMPLIANCE Date Rec'd
F
AND UTILITY CONNECTION
411vNESO�� 1. White File
2. Pink City PERMIT NO. /6, . / Z.2
3
i Yellow Applicant
.ase type or print and sign at bottom)
DRESS
-LE- ZONING(office use)
Lo 13 J - ) 5 OS -.)-. 5
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) i t-t. t �t S (Phone) / 6 Ed" y ti 3- 3 Jo y
(Address) 1
BUILDER
(Company Name) te..yn.Ct, c.,\ -le:,v 'Ahd.eC5-e fv (Phone) (DS 1 -aL 4- 1 U E)S
(Contact Name) (Phone)
(Address) 19 Z o CO. --?-.8. "c"� w,e 5.1- .)nope<.,-lif 1 r'N 5 511-2)
TYPE OF WORK ❑New Construction ❑Deck ❑Porch
ORe-Roofing ORe-Siding ❑Lower Level Finish Fireplace /
l
❑Addition ❑Alteration ❑utility Connection 1�ceai Irl wl y40w S p I O Q
P-
CODE: ❑I.R.C. I.B.C.❑
c
❑ isc. ✓�;rU —ems J5 _ �rifr
. `�
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ a 5 ) ( O7
upancy Group: A B E F H I M R S U /
ision: 1 2 3 4 5 (excluding Iand)
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-me tioned property and II. 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:. revoke this permit f. cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform nee •d inspections.
Signature Contractor's License No. Date
Permit Valuation j Park Support Fee # ( $
Permit Fee I $ SAC ## $
Plan Check Fee 1 $ 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 $
! f
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid 1E17TV j Rec!ipt No. —RTC)
Date i 0_1/0 ,' (, ! B •
Building 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
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows Construction to commence. Before occupancy,a Certtticate of Occupancy must be
d
illii
Planning Director Date Special Conditions,if any