HomeMy WebLinkAboutBuilding Permit 00-0837
~TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE _SCHEDULED . A .7"-
4~ ~ <:., fJn M<;s ~ ~(,L
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
60-~~'7
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION @ 0 SEWER HOOKUP
~INAL~~ ~ 0 PLUMBING FINAL
o SITE INSPECTIO 0 MECH FINAL
!<:::or:-- Is
COMMENTS:
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-r;.M,4r /-0
~S6- FrLb.
IWORK SATISFAiCRV, PROCEED
o CORRECT 10 AND PROCEED
o CORREC WI K'i LL FOR REINSPECTION BEFORE COVERING
Inspector: ' Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
(Address) (Tel. No.)
L,j),~A- I/fk..7 A./.~. t'~~./ifcr
(Ad~;"'~ Q ,Wi!' (Tel. No.)
fJ~t'CI..c... 2J)
(Add'.") xL.-~ .(TJL:~.!.- r7<7-X
/b<>/ d"N7.!.dVfrl:{~ V,,:l-~.~/
t.1..Et.R-:,_!f-/ev~~ C!o....S/": tI1DA ~~~.)..n/~Ity)?b/-fl/(f
~place 0 Septic 0 I Deck D Re-roofi~ Porch D
.J.)Alteratio~S D Addition D Finish Attic 0 Rs-siding 0 Finish Basement 0
K~/l~,A /~ ci S.-#.:t: _
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby carr that I have furnished information on this application which is 10 the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above en' n 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
buildi 0 revoke this rmit for j st.cjUse. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X . J LO! ql3?~ I P-/$.-66
Signature license o. Date
~~
JlI'T. ".".'11];11 CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
'k'{,'f' A.I. E.
1. DATE
3. LEGAL DESCRIPTION
&jm;,:;;/
()./1.0)p
A...ot. ~k
,
LOT
BLOCK
PID
ADDITION
4. OWNER (Name)
~. c) J :r -e-...",.... :J?>
5. ARCHITECT /!/j(;
6. BUILDER (Name)
7. TYPE OF WORK
New Construction 0
Chimney CJ Misc.
12. NO. OF S
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
B.ok
Side
Side
Front
- BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF IjW\LD:G
Il'e.... A./A'
"/
PERMIT VALUATION
2"'~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
SURVEY
PLOT PLAN
COPIES
LI
LI
R S U
7t.f. /~
Amount Brought FOlWard .................. $
Par1<SupportFee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... ,'I:
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... <t
Builder's Deposit ............................ $
Other ......................................... $ :s.
Total Du. .............................. $ 7t.
Receip~~o. ~
Dat. 1 ~/3. 20KJ f18y ft..J!...!1~J L
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 as requested.-Ji( 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'rnust be issued.
City:
Plan Check Fee ............................. $
State Surcharge ............................. <t
I . ? cc:.
Penalty ....................................... <t
Plumbing Permit Fee ....................... <I:
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~:'I . ..;~..l-:..~~.;e~tt~!:.""_:.'! ~1lVtC\
By 'P Date -7' "/17' ~
Certificate of Occupancv(/
Issued
Paid
$
24 hour notice for all inspections (952) 447.9850
Special Conditions ~ any
City Planner
Date