HomeMy WebLinkAboutBuilding Permit 00-0760
CITY OF PRIOR LAKE
INSPECTION NOTICE
StiT!EDULED
DATE TIME
t?- B-w.. ..4. T
ADDRESS 3~ 70 8/lSSW01)O (]AK-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNOATION 0 MECH RI
o FRAMING (BD WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~FINAL 5/0/#' 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
..
..",.-- --
/~.
( ~~
'-
.....-t" :'tJ ~ - 7(.0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
---
~)
~
0/ 0<.1
Ji/,A.'I
.> WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ I Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
QATF RFnFIVFn CITY OF PRIOR LAKE
BUILDING PERMIT,
~ ~yfcio TEMPORARY CERTIFICATE OF
r ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No._c()-0lf /,0
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
'~i6141c1}
BUILDING INFORMATION
11, SIZE OF STRUCTURE
IHelght) (WidIh) (Oep'h)
2SI$~S{J ~LA1\r}('1
3. LEGAL DESCRIPTION
S
I n(\o_
12. NO. OF STORIES
BLOCK
PID
(;)o- II ()-() 17- n
13. TYPE OF CONSTRUCTION
LOT
~
W;IIIl)~ ~rCl A-OOr-J
~dress) _ \
~'5;70 .\~S)"/MXJ
ADDITION
4. OWNER . ~arlfl>
~III SCHoLlU-v
5. ARCHITECT (Name)
(Address)
(Tel. No.)
l{4/' <)'; -S7
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
r~~~+ ~(
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations a
Aql ~ ~b/)s.+ ~
Septic 0 Deck 0 ~~~~g 0 Porch 0
Addition LJ Finish Attic 0 Re'Si~ Finish Basement 0
1Y6-6' 67
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATC::
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby c rti that I have fim' 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 'one propertyj 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 0 . ial oke t" p it for just cause. Furthermore, I hereby agree thaI the city official or a designee may enter upon the property to p~~~e~ed inspections.
X. ~A \l~ Y--l'1- to
SIgn~ - License No. .. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
D
~.
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS D PERCOLATION TESTS D
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~
PLANS & SPECS 0
SURVEY 0
PLOT PLAN D
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
OM,"01234 '/L/....,::s-
Pennit Fee ............................... .... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ..................... ........ ,>I:
State Surcharge ............................. ~
I. ~S"
Penalty ....................................... $
Plumbing PennitFee ....................... $
Pressure Reducer .......................... $
Meter Horn ... .... ..................... ....... $
Water Meter ................................. ot
Sewer & WalerConnection Fee ........... ot
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ........ ............. $ Water Tap ................................... ,ot
Builder's Deposit ............................ $
Other ......................................... ~.
CertHicale of Occupancy Paid T;'.;I~. UJ..............~~~~i;;~O$_~~~ ~
Issued /., / )
Th~ Is to certify 1hal1he requesl in the above application and accompaoying documenls Is 10 accordance wl1h the c~:;on~6rd:~ a~~ P'::ed a~-tf:f'.,ed, This documenl whan
signed by tile City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of ~~ncy must be issued.
City Planner
Date
Special Conditions n any
24 hour notice for all inspections (952) 447.9850