HomeMy WebLinkAboutBuilding Permit 00-0967
CITY OF PRIOR LAKE
INSPECTION NOTICE
SC;:HEDULI:D
DATE TIME
!l-3D-Qt) '-.1")
ADDRESS
4-/ CJ 0 e:;n.J C-c-I-l/ /<?-G
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV,
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o seWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
COMMENTS:
[
'U?~ f"Qu
~~ 1,0
./
P"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND ~ROCEED
o CORRECT W~R L. L =OR REINSPECTION BEFORE COVERING
. \
Inspector: V M~ Owner/Contr:
(J- () 9(17 7
o EXC/GRAD/FILLlNG
o LKSHOR~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
~
CALL 447-4230 FOR THE ",EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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pATF RFr.= CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I, White
2. Pink
3 Yellow
File
City
Applicant
- DIRECTIONS
SPACES NUMBER EO 1 THRU 17 MUST BE FILLEO IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRES2../1 QO
f' ~!lv c. / qcfe..
Permit No.Oo-Oqlc.?1
ilfi/<<J
PU5D
PID (~5 -:J3~-C>db' ()
~,-L
BUILDI.FORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
3. LEGAL DESCRIPTION, j
LOT ~f BLOCK
ADDITION I Vk11 tL.v~ Cj
-~
t{Ci571t:-
:-:;-
lJ"1 "'-ti1
(Name) j (Address)
f'h ,BAov/ l.f /9'0 &qu C!6-. .,,~
(Name) f.,. _l' \ <? -(Address)
l:!.Teve:.) '- 1,;.>-<<
~ S~"li...r(AddreSS)
e:. C;-01" E '1q'f1 5'T (17/6
Deck 0
Finish Attic 0
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. OWNER
mIl''' /,(
15. ARCHITECT
6. BUILDER
(Tel. No.)
~l/7- 4/'10
(Tel. No.)
14. flOOR AREA APPORTIONMENT USE
(TeL No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
%'?- JC1.:?O
SEATS
New Construction 0
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 J 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
buildingj!tticifl can rev~i~ permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform nee<j.ed ins~tions.
X <:4? L..P( ~ ?a?~~(') IIF}/cc>
~ - Signature License No. Date,
Fireplace LJ
Alterations LJ
SepticLl
Addition LI
Re-roofing)il' Porch LJ
Re-siding LI Finish Basement LI
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Baok
Side
Side
SOIL TESTS
LI ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS LI SETS
USE OF BUILDING
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
0"";00 1 2 '4 '7U"7 r
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ......... .... .... ...... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
state Surcharge ............................. $
Penally.......................... ............. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ............. ........ $
/ r.;;2 5""
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .........71.)"............... $
Certificate of Occupancy Paid '/~'" / C Receipt ~.fl. ,=3 R'" ,=>.S- I
Issued
Oa1. /{-/,.,-(JO By ~..
This is to certify that the request in the above application and accompanying documents is In accordance with the City Zoning Ordinance and may proceed a~uested. This document when
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 issued.
This Application Becomes Your Building Permit When Approved.
By Date
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447.9850
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