HomeMy WebLinkAboutBuilding Permit 00-0826
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 24'15
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~ o..)NSULA~N
}!I\.FINAL J:"
o SITE IN PECTION
COMMENTS:
No
DATE TIME
SCHEDULED [6 - ?.-
['set.L-li.. QJ.
CONTR.
PERMIT NO.
0(') ~2.L.
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
,1c ~ IS
( I P.. f). y-
+n .-j"~ IU-V'
\
T\
C~JyL
:Lr
o WORK SATISFACTORY, PROCEED
X.CORRECT ACTION AND PROCEED
o CORRE~fJCALL FOR REINSPECTION BEFORE COVERING
.
Inspector: -l.L. Owner/Contr:
CALl! 447-~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
- .../
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
'''''"'''
~1
j;2ATF I=U=r:I=IYfQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
{.
'..J
...~oy
I. White
2. Pink
3. Yellow
File
City
Applicant
9- /3--C/V
Permit No. () 0 ,og &h
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
2. SITE ADDRESS
:1tJ't~ /5tf. ..JIJ . g. .f) L
1. DATE
Cj'-/;;J-t!JO
BUILDING INFORMATION
11. SIZE OF STrl:';t:'~-URE
(Height) (WIdth) (Depth)
3. LEGAL DESCRIPTION
LOT
12. NO. OF STORIES
~LOCK
PID 2-5 -"133 - ODS - z--
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
"'T'''--f'~ .fh~ IIIJ)('I!/
5. ARCHITECT (Name)
(Address)
;;;) <j:jJf IS 4' ~ S7.
(Address)
(Tel. No.)
'I-IS-"i./7.R
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
7. TYPE OF WORK
New Construction LI
Chimney 0 Misc.
Fireplace LI
Alterations LI
(Address)
~,.,..L;. _ ~SV 4J ,;)OO,s.,<.
'4T'<"( :r rrt/).lJnJ
Septic LI Deck LI Re-roofin~ Porch LI
Addition CJ Finish Attic LI Re-siding 0 Finish Basement LI
(Tel. No.)
'Ira.- JPtfa
I 15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
/11lJ<<2 ~
SEATS
16. PROJECT COSTNALUE
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
t hereby certify that I have furnished information on this application which is to the besI 01 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
building ~~I c,,!n If!..vf).ke t is ermit for just caus, Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
X 7tWCk _ VL./ . q-I.J. _()()
Signature License No. Dale
17. COMPLETION OATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
B.",
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
,p~J4f/
. OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
PelTTlitFee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ......... .... .... ...... <I:
Sewer Tap ................................... $
$
74. 7 r
Plan Check Fee ............................. $
State Surcharge ............................. $
/.--z...r
Penalty ..... ..................... ..... ........ $
Pressure Reducer .......................... $
Meter Horn ........... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7~. 11 (.I
Paid 7 {; . aU Receioll!" 38> He
Date q'/:?"fI _ ~'t...../fIt;..
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may prOCeedis requested. 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.
Plumbing Permit Fee ....................... $
Mechanical PelTTlit Fee ..................... $
Sewer & Water PelTTlit ...................... $
Gas Fireplace PelTTlit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
CityPJanner
Date
Special Conditions ff any
24 hour notice for all inspections (952) 447-9850