HomeMy WebLinkAboutBuilding Permit 00-0779
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS I fn 5 S- to
SCHEDULED ~/3~o
< \',k'RING Ave,
I~: cJo
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0-779
o FOOTING
o FRAMING
o INSULATION
. PINAL
/0' FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SewER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAOIPILLlNG
o LKSHOREnMETLANO
o COMPLAINT
(p 0 SEPTIC FINAL
o FIR~CE--4
~~.,.
,.
COMMENTS:
~RK SATISFACTORY, PROCEED
I' 0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ....-, Owner/Contr:
CALL 447-4230aOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
.--- --,...--.---..-.-.-
,~-,_. ~---_...,_..
~~
QATF RFr.FIV~ CITY OF PRIOR LAKE
Q 30 () 0 BUILDING PERMIT,
o . " TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
06.71q
,
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
71?';-h S~/J/r-/f&-<./W
:: ;~TC :E::~IP~ON
1. DATE
.~AOh()
/ /
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
lOT
BLOCK
PID
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)...J.... ~
(Ii( /II\J?,0/(jI7
5. A CHITECT (Name) -. -
(~~) (Tel. No.)
/b~L;b ~X:A~IIL/. ~.lv. 4'ij'J/~
(Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
~((~:'I J~J~ir(:?:.1l /~~-/ ~4;!:ofin~L,l7 ;:~IIL
New Construction LJ Alterations [j Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 mentio r~perty ~~nstru.9ion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am c:'~ that the
:uilding official n r.v k I' ~'/1 ,J!!...rmor.. I hereby .gree thaI the cily official or a designee may .nler upon Ihe property to pert~ l..fPld'O'
/ / Sig"'g';V:~ "'l-- License No. - Dat6"
1/
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~~
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... ................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
747r
Plan Check Fee ............................. $
/.-z....r
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... It
Pressure Reducer .......................... $
Meter Hom ....... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ~
WaterTowerFee ........................... $
Sewer & Water Permit ...................... (:
Gas Fireplace Permit ....................... It
Water Tap ................................... $
Builder's Deposit ............................ $
Other ..... .... .... ............................ $
Total Due .............................. $ 7(,. cJo
Paid 1(". cJU Rec.iP~.I~ !:> r?...(, b
Dal. ~. f.o,C/L.I By ~
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 rf. 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.
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions it any
24 hour notice for all inspections (952) 447.9850