HomeMy WebLinkAboutBuilding Permit 09-0135
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS -'..s8tJC;
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
9- ~NSULA TION
~INAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
1-1/1 ?~
v-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~/nl,J(1
J \ V I' l
DATE
s/rl r/1
I ,
TIME
9--' /~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.r\ 1'\
A{ I) \Ir
~ '\/)/0 \t:1I j Y. \. 0
-- ,- 6'-" 'I . ~I ~ "T'
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE{&CK' CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
,CALL 44 ~- 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTl
~\
DATE RH";FIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITEbD;RO~ M /) cr e~i 1"' .J r ~d IV [;
3. LEGAL DESCRIPTION
Permit No.
act- OIS~
1. DATE
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
PID
ADDITION
4. OWNER (Name)
kj~ tel n\-V^C\-
5. ARCHITECT (Name)
13. TYPE OF CONSTRUCTION
(Address)
(,.,~(}t JI,/kr~J.f ST- N f
(Address)
(Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
9.$" cJ. '/'/tJ .~.h~
(Tel. No.)
6, BUILDER
(Name)
(Address)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
15f.t1 U L.{".j c.,.. ~ r(~.)J~ s
7. TYPE OF WORK
Fireplace 0
Alterations 0
(\ \ (Tel. No.)
'sS'10t b I ~
XII AhNJJ^ A.\. 8~1:S~ ~I
Septic 0 Deck 0 V Re-roofing 0 Porch 0
Addition 0 Finish Attic 0 Re-sidingJ5l( Finish Basement 0
SEATS
16, PROJECT COSTNALUE
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished information on this application which is to the besl 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
:uildin~ r:oke thi~i~~urther~ore, I hereby agree that the city official ~C::je J[/~er upon the property to perto.:5he/Oqtions.
-/' (~ I ~'::'(re License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
SURVEY
PLOT PLAN
o COPIES
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ........................,................ $
Collective Street Fee ....................... $
SewerTap ................................... $
$
7t..J.'5
Plan Check Fee ............................. $
State Surcharge ............................. $
/. J--~
I L(., ~
Pressure Reducer .......................... $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Meter Horn ................................... $
Water Meter....,............... ............. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Builder's Deposit .................~..........
Other ................ ...................... ..
Total Due ..........:.;,;.>'........... . $
Paid I rO, "'1J Rec t No.
Date j. '-l u tf }- .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance ahd may pr~d~s requested. This document When'
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cert~of Occupancy must be issued.
Certificate of Occupancy
/< D. IS
fn(,/
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections (952) 447-9850