HomeMy WebLinkAboutBuilding Permit 00-0816
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHED,ULED
ADDRESS
4-Bcl,3 (t~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING (J
o INSULATION
'lir"FINAL UD~
t'D- SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBI INAL
o MECH
COMMENTS:
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DATE TIME
1.:/~'UV A.-T.
() - SI b
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
lNSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~~
t2A TF; RECEIVEQ
9./z'00
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 ) /r". C.2
q)J 7 J ~,.,d~fi'
3. LEGAL DESCRIPTION
LOT
BLOCK
PID
1. DATE
9-./;;2.00
k' S'c..~
Z6-o17- 074-0
ADDITION
4. OWNER
(""7t '
///1, ~
(Name)
/' (Addre~......
.....J,t1,L/t L/n3
(Address)
5. ARCHITECT
6. BUILDER
/J (Nam~ L f/ t (Addr,,*
f<..rif!VY tf#Izr,Or-7(
L/ ':let) D~ (4 f?.f :;r 5~
7. TYPE OF WORK
New Construction LJ
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
/(/ ;5'
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No. ---1ln . 0 ~ ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
~
tv,(J~;::) 1..('/7 8?~ /'4. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
flc
(Tel. No.)
lIef?- 2fS'O
Re-roofing ['I Porch 0
Re-siding ['I Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney Q Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I hav mis ed information 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 mentioned p pe t all construction will conform to all existing state and local laws and ~iU proceed in accordance with submitted plans. I am aware that the
building offici~n re i rm~ just cause. Furthermore, I hereby agree that the city official or ~si~e. e may enter upon the property to perto~i:.inspections.
X 't &. ~ a-, 7"'If 0{) l' '~I /- ,,~
I I Signature license No. - Date
17. COMPLETION DATE
- SETBACKS: Required
Actual
Back
Front
BUILDING DEPARTMENT VALUATION
FOR ADMINISTRATIVE USE
Side
Side
USE OF BUILDING
/!?ES I'ItIZ-
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCllON: I 11 III IV V
Occupancy Group A B E F HIM R
Division 1 2 :3 4
S U
Permit Fee ................................... $
i4-.75
Plan Check Fee ............................. CI:
J . z..S"'
State Surcharge ............................. ~
Penalty ....................................... $-
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fire
This
By
Issued
CijyPlanner
Date
24 hour notice for all inspections (952) 447-9850
Spec~1 Conditions it any
Z,.sIl1) . dV
MATERIAL FILED WITH APPLICATION
SOIL TESTS ['I ENERGY DATA ['I
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS ['I
SURVEY Q
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........ ................... $
SAC ......................................... $
Collective Street Fee .......................!l:
Sewer Tap ................................... $
$
City:
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
By
Total Due .............................. $ -, (P. 0 U
Paid -J f. . 0 0 Raceip
Date '!. 1'1, . 0 ()
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 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.