HomeMy WebLinkAboutBUILDING PERMIT 16-0721 , DATE TIME
CIT(
INSPECTION OF PRIOR LAKE pl
NOTICE SCHEDULED 1 ((-/
ADDRESS 10 \
/
CONTR. 7 L /
OWNER �!Cj°
PERMIT NO.
PHONE NO. ❑ GRAD!FILLING
❑ PLUMBING RI 0
❑ FOOTING 0 MECH RI 0 COMPLAINTPLA
❑ FOUNDATIONR0 WATER HOOKUP 0 RIINAL
❑ FRAMING 0 SEWER HOOKUP 0 FIREPLACEREPAIR NAL
❑ INSULATION 0 PLUMBING FINAL 0
Zj FINAL ❑ MECH FINAL _ov-%
❑ SITE INSPECTION
COMMENTS: I.T
At %s•
I ,
❑ WORK SATISFACTORY,PROCEED
O CORRECT ACTION AND PROCEED
CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
v/ QWner!COntf:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
1NSNOTI
P9Date Rec'd
p R1 .p CITY OF PR1OR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v ��ti AND UTILITY CONNECTION PERMIT t�
r�'NES°4. �� 1. White File
2. Pink City PERMIT NO. ( .. (
3.Yellow Applicant
fillease type or print and sign at bottom) ZONING(office use)
ADDRESS
4.11) I Willowvlrood Street SE. Prior Lake, MN 55372
LEGAL DESCRIPTION(office use only)
PID
LOT BLOCK ADDITION
(NamOWNER Michael Cichosz (Phone)
952-855-9418
(Address)* tNillowwood Street SE
BUILDER (Phone) (651)784-2646
(Company Name) Custom Remodelers, Inc.
(Phone) (651)784-2646
(Contact Name)
(Address) 474 Apollo Drive. Lino Lakes, MN 55014
Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
41;i
TYPE OF WORK CI New Construction ❑Deck ❑Porch ❑
DAddition DAlteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. QMisc:
I H IH ry V A B 5,902.00
PR
ype of Construction: OJECT AL) UE $
ccupancy Group: A B E F H I M R S U (excludiCOST/Vng land)
)ivision: 1 2 3 4 5 Window Replacement
ct. I also
rtify that I am the
er or authorized
t for the
I hereby certify
that
at I have and furnished
all construction will conform to all existing state and loest of cal laws and wiowledge ll proceed ine and e accordance ewith submittedlans.n I am aware that the building
obove-manro p p rtY
official can revo,- + is permit for ju? se. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed J u ne123 rdn2016
s.
CR001748 Date
X /'' '1/ S/1- Contractor's License No.
Signature
Park Support Fee # $
Permit Valuation SAC # $
Permit Fee $ $
$ Water Meter Size 5/8"; 1";
Plan Check Fee $
$ Pressure Reducer
State Surcharge
$ Sewer/Water Connection Fee #
$
Penalty Water Tower Fee # $
Plumbing Permit Fee $ $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $
TOTAL DUE
a" Recei•t No. e CI '
This Application Becomes Your Building Permit When Approved Paid `C. B
Date C':- 2-
Building Official Date
is is to
in
application documents
accordancecommence.
proceed as requested.
document
en signed by the City Plannerconstitutes es a porary Certificate of Zoning compliance and allows construction to comm nceBefore occupancy, Crtfica eofOccupancy must
•-ed.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372