HomeMy WebLinkAboutBuilding Permit 00-0773
ADDRESS
L/O 9 :5
DATE TIME
SCHEDULED ~ A, j;
~'A-uCLAff2E~ CL,
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7/3
o FOOTING
o FRAMING ((t)
o INSULA liON
FINAL
~ FOUNDATION ~
o DEMOLITION
o FIRE PREVo
COMMENTS:
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER. HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
I!e - ~r--
o EXC/GRAD/FILLlNG
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
,f' '""'1 ~:J
~
/ ~
'-
~
f~ AJ/J>'-'U
~~.
..:"""~
>.~ ~
~e ')
_.-/'
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~L FOR REINSPECTION BEFORE COVERING
Inspector: tr .f { Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
B. z,?Qo
Permit No.
00. 0173
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
8.Z9.00
2. SITE ADDR~~ 9("' ;;!/Ur
(j1tJ/r! CY
5
W/N OSO/'lq
(A~dress)
Sell/nMI <fJ9f' f#t d9~(y
PusO
BUILDING INFORMATION
, 1. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
II
12. NO. OF STORIES
LOT
BLOCK
PID
2.c;~73.fo- tJ27~()_
,
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER IJ (Name)
rW$5
5. ARCHITECT (Name)
(Tel. No.)
Y<l7 g1l8'5-
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
6. BUILDER (Name)
~~ ~~U:V
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
~ ?'7ql~/~Sf f'?-no
Septic 0 Deck 0 Re.roofil1i'8j Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation 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 mention perty an at 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 offici n re oke tho it for iust cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to pertorm needed inspections.
"/- A? ----.
17. COMPLETION DATE
x
license No.
0."
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
..e~ A-/..t:..
'/
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2~ 5(51J. dU
PLOT PLAN
o
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:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... ................... $
Sewer Tap ................................... $-
.
74.7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ............................... ........ $
Plumbing Permit Fee ....................... $
/.Z,..r
This
By
Certificate of OccupJcy
Pressure Reducer .......................... $
Meter Hom ................ .... .... .... ....... <t
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ......................................... ,<I:
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
ToralDue .............................. $ 7(0.00
Pa;d 7~.cJb Rece;~:3B2t:J3
Date "'Ztj,~ 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 alrequested. This document when
signed by the City Planner constitutes a tempora'Y Certificate of Zoning compliance and allows construction 10 commence. Before occupancy, a Certificate -~ Occupancy must be issued.
Issued
CityPJanner
Dale
Special Conditions n any
24 hour notice for all inspections (952) 447-9850