HomeMy WebLinkAboutBuilding Permit 00-0785
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
t.!nG(.
E aU C:(6(~-'"
OWNER
CONTR.
OATE TIME
q-jiJ
r-
/,.,-
PHONE NO.
PERMIT NO.
O~7x--f"
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
V-<' - f()~
COMMENTS:
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
I/i'"\VORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ---1L1-f q. Je) ,(/J Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
ual<<)n
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SIIFETY/
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
8-3/- 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
1, DATE
~I/('.
fS-3/-oo
N. E.
oc,{,
~ UA<..("c
3. LEGAL DESCRIPTION
3
PID
7&:;-OB9 -OtJ3-l)
LOT
BLOCK
ADDITION
H7:\'
4. OWNER (Name)
~' €"lf.-
5. ARCHITECT (Name)
(Address)
,(/ S
5"~L
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
WI"';OOvJ
~ >\Dl"-'t-
Septic 0
Addition 0
(Tel. No.)
If//o V-"L"Y )"'D tkll.P. $'.
5t+~o I'U: if9' -( 104
Re-roofing eo- Porch 0
Re-siding LJ Finish Basement LJ
Lo.f?6.J
(NOt-!" €-
7. TYPE OF WORK
Fireplace 0
Alterations a
Deck a
Finish Attic a
New Construction a
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. (Ob,c
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Ves
No
,30
t:.f q L White
-JP 2. Pink
3. Yellow
File
City
Applicant
Permit No.
5"
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
I
13. TYPE OF CONSTRUCTION
~ A'aoF
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
J.. if' VO
17. COMPLETION DATE
I hereby certify that I 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
bUilding~an r voke 's permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X - 1&<:1 fJ.-3/-00
Signature License No. Date
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
USE OF BUILDING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City'
-;4-, 7r;'"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I. 2.S-
Sewer & Water Permit ...................... $
This A
By
Paid
.00
i1ding Permit WlJAn ~~ved.
Date 'elj' S'" ()?
Issued
MATERIAL FILED WITH APPLICATION
SOIL TESTS
a ENERGY DATA
o
PILING LOGS CI PERCOLATION TESTS CI
PLANS & SPECS 0 SETS
SURVEV
PLOT PLAN
a COPIES
o
Date e<l f.Ul)
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee 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 Certifi e of Occupancy must be issued.
City Planner
Date
Speciai Conditions ~ any
24 hour notice lor aU inspections 447-9650