HomeMy WebLinkAboutBuilding Permit 00-0713
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS \ 4-2.11
OWNER
PHONE NO.
o FOOTING
o FOUNDATION tJ
o FRAMING
-2 ~~~LATION
o SITE INSPECTION
SCHEDULED
~V'L Lc~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~ ~
l&rA
I
k'?
~
~
TIME
l\ %
6-7/3
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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(/ ~
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~
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~
,M
JjWORK SATISFACTORY, PROCEED
(~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~( Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~~
Q~,TC QCr;CI\,.EQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Permit No. [o-i/3
1. White
2. Pink
3. Yellow
File
City
Applicant
~ II sf (Jf;"
- DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
New Construction 0
Chimney 0 Misc.
/ao 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 10 the best of my knowledge true and correct. I also certify that I am tile 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
:Uilding offici I can revo e ::rrnit tfS1~~rrnore, I hereby agree that the city Of~ ~ i d~n~ j"Y ~eSon the property to pertorrn ?'i.l ~7~OZ-
Signature LICense No. Date
2, SIT?ft:J./1
3. LEGAL DESCRIPTION
I~
LOT
ADDITION
6, BUILDER
I1re.u~(
7, TYPE OF WORK
';; c:Joo
I
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
Sh{J'{f
Lof\OllJb
..3
PID
~ 5-<<1S'039-O
12. NO. OF STORIES
BLOCK
<),
13. TYPE OF CONSTRUCTION
(Address)
I' iT?- No.) 5
L .., 'J -011
14, FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
(Name)
(Address) JO yrdar\
-x,S() W dOUff,
(Tel. No,)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Iff,:}. - 3 ~'f ol.
&f7i'1.ot..
Fireplace dI
Alterations 0
SEATS
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing)l(... Porch 0
Ae-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
17. COMPLETION DATE
<6'1/5/00
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Back
Side
USE OF BUILDING
BUILDING DEPARTMENT V ALUA TION
~ Me
OFF STREET PARKING
SPACES REQ.
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
S U
City,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
74,76
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
I. d,,,"
Pressure Reducer .......................... $
Meter Hom ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
it ....................... $ Water Tap ................................... $
m YcjJr l3uildlng Permit Whent~P7Lr ;...... Builder's Deposit ............................ $
:,MM>.. Date ~ h~1...!J Other ......................................... $
I
Certificate of Occupancy T07ta' ~ue 00........................ $
Paid k Receipt No.
l~ ~
Date $//!;>/~ By (
b '
This Is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdinance and may proceed as
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate
7.f.., 00
'If.;tO 7
City Planner
Date
Special Conditions if any
24 hour notice for all inspections (952) 447-9850