HomeMy WebLinkAboutBuilding Permit 00-0809
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIMe
SCHEDULED
t.L/.t'J
ADDRESS
42)'-1
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(/)fort/el" <;:-r
OWNER
CONTR.
.--
PHONE NO.
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o EXIGRAD ILLING
o COMPLAI
o FIREPLACE R
o FIREPLACE FINAL
o GASLINE AIR TST
o
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
j;rFINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o WORK SATISFACTORY, PROCEED
tfCORRECT ACTION AND PROCEED
o CORRECT W~R'l7ALL FOR ~INSPECTlON BEFORE COVERING
Inspector: Y [If/ ~ -4 - 0 /' Owner/Contr:
. .
CAll 447-"R50 FOR THE NEXT INSPFCTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY!
lNSNOTl
--009
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QATF RFIOFIVFn CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 00 - OMct
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
LJ::).Jl..\ CO{00>tJD Si S[
q}~/CJO
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) {Width} (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
5. ARCHITECT
BLOCK
G.OV. s.,.~
~~~wJ
(Nam'l)
PID 2-~'=L'::l-1~
13. TYPE OF CONSTRUCTION
LOT
ADDITION
4. RWj'lER
;\1'e.u~
(Address)
4').)-Lj CoIOr"lJo st S6
(Address)
(Tel. No.1
CfS').-447- :;'441.)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.1
15. NUMBER OF OC9jPANTS OR SEATS
OCCUPANT~ ."..,
7. TYPE OF WORK Fireplace 0 Septic 0
New Construction 0 Alte~tions D \ Addition 0
Chimney 0 Misc. J,0 f~ aa W _
6. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that 1 have furnished 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 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
~Uild~1 can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature License No. Date
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-sidin~ Finish Basement 0
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS ("J ENERGY DATA ("J
PILING LOGS ("J PERCOLATION TESTS 0
PLANS & SPECS ("J SETS
SURVEY 0 COPIES
PLOT PLAN ("J
SETBACKS: Required
Actual
- BUILDING DEPARTMENT VALUATION
USE OF BJ1ILDING J_
~. ~ IlL
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
'A. 6cO. 0/5
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee .................. ................. $_
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
R S U
City:
Amount Brought Forward .................. $
Par1<SupportFee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7l/. fie;"
,.2C
Issued
Total Due .............................. . 7{,.oO
Recejjll"NQ, ~ CI~
Date er - ~ - ')(')0 a/ m
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;- 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.
Ing Permit ~~~roved.
Date ,'r:; _ (Ja:1
Pressure Reducer .......................... $
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... ~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
............. $
Certificate of Occupancy
Paid
City Planner
Date
Special Condrtions if any
24 hour notice for all inspections (952) 447.9850