HomeMy WebLinkAboutBuilding Permit 00-0966
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I Lj I? '<;? 2sr/l7c
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING &J
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: C;:--W- e--:,
~LU ~\
DATE TIME
Io/~ 9,'56
Me, /
6- Cf(P fa
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ALL FOR REINSPECTION BEFORE COVERING
Inspector: ( ~ ( Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
_._-_._.~--_.
DATE RECFIVED CITY OF PRIOR LAKE
- BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Permit No
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
1.
2
3.
')-'30~
f</5D
PID ;;2.5'- 130- ()Jo-o 12. NO. OF STORIES
113. TYPE OF CONSTRUCTION
14. OWNER JNatne) (Aq~re18) k (Tel. No.) ,I 14. FLOOR AREA APPORTIONMENT USE
~l"''''o.. '1 ";.tl\\~ \l.1""-6 37 f.~1''':1e ,.....w.- S.!;
15. ARCHITECT (Name) (Address) (Tel. No.) ,I
6. BUILDER (Name) (AddreSS).1-.. (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
7:~~:~Cf C~:~~;a~:' 1Is:~c~' \~~;\ ~~R~!n~t-tLf:c:;dj :::::ANTS
~~:~:;~ru:::.D Alterations 0 Addition 0 FinishAtticoC\,se-~:~ ~nr1=:~ 16. PROJE\\CO~~~~~
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1'0. CULVERT SIZE 17. COMPLETldN DATE
Sq. Ft. Width Depth Yes No \ \ - \"L..-~
I hereby certify that I have furnished i formation 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 mantio d pro and t al construction will conform 10 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding offjcial ca voke 5 pe rtharmors, I hereby agree thaI the city o~~l:feSjgnee may enter upon the property to perton ~~spections.
License No. Dale
2. SITE ADDRESS \ LfC-b '57
3. LEGAL DESCRIPTION
~'5t(~ J\~.
sL
SeCT :30
(Depth)
LOT
BLOCK
ADDITION
FOR ADMINISTRATIVE USE
I
I SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Saok
Side
Side
SOIL TESTS
[j ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS Ll SETS
USE OF BUILDING
SURVEY
PLOT PLAN
[j COPIES
o
TYPE OF CON$TRUCTtON: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC .........................................It
Collective Street Fee ....................... It
Sewer Tap ................................... <t
$
Plan Check Fee ............................. $
State Surcharge ............................. $:
Penalty.................. ..................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ................................... It
Water Meter ................................. It
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid -Jla. - Receipt NOc-=3 Q(.SO
Issued lA ~ : _
Date I(~ 3 -00 By ~- lJ&UA/I9-
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's 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 Occupancy must be ISSUed
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Condrtions if any
24 hour notice for all inspections 447.9850