HomeMy WebLinkAboutBuilding Permit 00-0745
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIllE
SCHEDULED ctt Ufa3
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CONTR.
PERMIT NO. -8< 7Y5
ADDRESS
OWNER
I tjj0Cf4
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR~
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector.
c:J4-
Owner/Contr:
CALL 447-9~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INMOn
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--...--.---...-.....----.--, ,
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
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3. LEGAL DESCRIPTION
LOT _Cl"p{',1... Q~
ADDITION
DATE RECEIVED CITY OF PRIOR LAKE
! )',n) BUILDING PERMIT,
?f cJ..,7. Ul.ltEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/'
l.
2.
3.
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l
White
Pi""
Yellow
File
City
Applicant
d(,
Permit No. <5D - 0 74 S-
1. DATE
<is/dOl/Of)
I I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
f(l~oJ C ~ oJ,
BLOCK TlAl P II S-
R..-N b 6 Ol~
12. NO. OF STORIES
~s- 'lQ3-0J~--O
PID
13. TYPE OF CONSTRUCTION
4. OWNER 1 J .(Name)
t:iL.I f h
5. ARCHITECT (Name)
6. BUILDER
14. FLOOR AREA APPORTIONMENT USE
. (Address)
Ucv.I: S4~
'!1Lltfc.AddreSS)
<rz;s~ /8lN
(Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
~~~~. ,,-{9d.'~~
Re-roofing)1' Porch 0
Re-siding 0'/ ):inish Basement 0
~~
Septic 0
Addition CI
Deck 0
Finish Attic 0
7. TYPE OF WORK
New Construction 0
SEATS
16. PROJECT COSTNALUE
Fireplace 0
Alterations 0
17. COMPLETION DATE
Chimney 0 Misc.
- 8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yas No
1 hereby certify that' 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 fOf
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 official can r yoke this p~for just cause. Furthermore, I hereby egree that the city officiel or a designee mey enter upon the property to pertorm needed inspections.
X 0 ~J{U.LJl4.A./ 1fl1 ~3f 7S ;I" ~ ::J;;l-Oo
~ r-- - S'ignalure ~ License No. Dale
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
BUILDING DEPARTMENT VALUATION
Front
Back
Side
MATERIAL FILED WITH APPLlCA nON
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLA nON TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
w\~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING"r
IU.2:,
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... '1'.
Sewer Tap ................................... $
$
TYPE OF CONSTRUCTION: I 11 111 IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 .,L-f I IS-
Permit Fee ...................... ......... .... $
Plan Check Fee ..................... ........ $
\. :15"
State Surcharge ............................. <t
Pressure Reducer .......................... $
Meter Hom ........... ........................ !t:
Water Meter .................................!t:
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... <t,
Water Tap ................................... <t
Builder's Deposit ............................ $
Other ......................................... $.
Issuoo r:::t1~~.......::~.~~:;;~0$ f ~ a~
ThiS IS to certify that the request In the above application and accompanYing documents IS In accordance With the City Zomng Ordinance and may proceed uested. ThiS document when
stgned by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construction to commence Before occupancy, a Certiflcat of pancy must be ISSUed.
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... !f;
Sewer & Water Permit ...................... $
City Planner
Dale
Special Condillons if any
24 hour notice for all inspections (952) 447.9850