HomeMy WebLinkAboutBUILDING PERMIT 16-838 DATE TIME
CITY OF PRIOR LAKE SCHEDULED
• TION NOTICE
ADDRESS
I 1 .. -/
OWNER
CONTR.
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PERMIT NO.
PHONE NO. ❑ GRAp1FILLING
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0 PLUMBING RI 0 COMPLAINT
❑ FOUNDATIONFOOTING 0 MECH RI ❑ COMPLAINT
❑ A 0 WATER HOOKUP 0 RIINAL
0 FRAMING 0 SEWER HOOKUP 0 FIREPLACEREPAIR TSL
❑ INSULATION 0 PLUMBING FINAL 0
AS/FISITE 0 MECH FINAL
NAL INSPECTION
COMMENTS: _r '—
Alb
0e-ie, riral 44
WORK SATISFACTORY,PROCEED
/`❑ CORREC r ON AND PROCEED
❑ CORRE' •'K,CALL FOR REINSPECTION BEFORE COVERING
Inspector.
i
)1111 Owner/Contra
CALL 44 -9550 FOR THE NEXT INSPECTION 24 HOURS INADVANCE.
SA
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL
INSHOTI
of ?Rio+ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
f TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
x cm AND UTILITY CONNECTION PERMIT
Z1
x
*IN NESole' I.White File
2. Pink City PERMIT NO. /6,_ 9 3 b
3 Yellow Applicant
type or print and sign at bottom)
DRESSZONING(office use)
I (40�� 4 i e/c) U 'I4J,,, gd . ivy..
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID .
OWNER
(Name) S rNC3 - 0YSGOC�l' ,,\c OrND (Phone) <J t9N . ' C - `/ �U
(Address)
j BUILDER
(Company Name)?ity e.wo,\ $uJ 'Ar��.(S-e tv (Phone) (DS t- f.U1"i-Li d f58
(Contact Name) (Phone)
(Address) Viz U Co• rid. "G'• w,es1�"'t�o�ec,i11e, r`tliv 5S!1?,
TYPE OF WORK 0 New Construction ['Deck DPorch DRe-Ro n�g e Re-Siding ❑�Lo�wer.Leve Finish 0 Fir tape Cu 'o
❑Addition ❑Alteration Dt tility Connection {� I au c W l b� `
0 Mlsc
CODE: ❑I.R.C. ❑I.B.C. /
e of Construction: I II III IV V A B PROJECT COST/VALUE $ `
panty Group: A B E F H I M R S U (excluding land)rsion: 1 2 3 4 5
I hereby certify that 1 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 prope and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thatthe uildtng
official can revoke this rmit for just cause. u hermore,1 hereby agree that the city official or a designee may enter upon the property to perform nee ns.- ions �(459
Signature Contractor's License No. Date f
Permit Valuation I Park Support Fee # $
Permit Fee k $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
t Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid \) t\. 6t3 ' Receipt No. (c." .4 O
Date // �7 ' /p BY 53
r (
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 Certificate of Occupancy must be
d
Planning Director Date Special Conditions,if any