HomeMy WebLinkAboutBuilding Permit 00-0653
DATE TIllE
CITY OF PRIOR LAKE Cl-l () -((]
INSPECTION NOTICE SCHEDULED
ADDRESS 15:>'-12> f?LJ;"1 bdY71TA i,
"
OWNER CONTR.
PHONE NO. PERMIT NO. (J- Cf"1
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: !-(' - rOlJr
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~RKSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ q - ;,(J .~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPUANCE
AND UTILITY CONNECTION PERMIT 1"'\ '" r--. r_ ~;z.
571 5) PermIt No.~, \. I - \ I~<..J
1. DATE
7/71<;/ D6
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Pi.... Print or Type and sign at bottom)
2. SITE ADDRE~ I I
/5 ?'t?-' Zd:V7horo~a hAt/I'" ))7:
3. LEGAL DESCRIPTION
LOT A'1) rl, Sf BLOCK
ADDITION _Mo.~~. ~~
4. OWNER } iNlune)
1Sin L4j.u-d /~V~
5. ARCHITECT (Name)
-..J
PID <SlS- (')7,( - ,..J;J,,-O
X:1'\. " ~ 0. o.v\..l.b
C- ~drer) (. (Tel. No~)
~I1nJM!b t.O 12?at,- .<:t:oO
(Address) - - [Tel. No.)
-j
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
,3-.1
19. PROPERTY DIMENSIONS I 10. CULVERT SIZE 17.CO LETIONDATE
WId1h Depth Ves No q ~~ } DTI
I hereby certify that I have furnished Information on ttis application which is to the best of my knowledge true and correct I also certify thatif' am the oWner or authorlz9cl agent for
the above mentioned property and that aU construction wfll conform to aU existing state and Iocaf laws and will proceed In accordance with submitted plans. I am aware that the
bUllZjitil19 . can revoketh~ permk lor st "'/1(8". F....,. ..... .,J, I hereby agree that the clIy otIIc:'9l or a d~ mey enter upon the property to ~ ~ed Ins~ns.
X ~ r. ~~ 't-d,";l'-\ , I ~~:/Ol)
./1 - i-I. lJcenoeNo. -e ""'" I
I
I
(Addrees) /'"; (Tel. ~o.) ·
,;;j 7t'/ - ~/~ P, f1/t! S V,d )-l).,)Cj-;J,3~ ~l
Septic 6 Freatil19 a Plumbll19 a Rerooflnlllt Porch a
Addition LJ Rnlsh Attic LJ Residing LJ Rnl~ment LJ
~'.IlUILDER ,/J(Na~ /J
f!d.c; I Y'Iv ~O.!Jt/rc. Le>
7. TYPE OF WORK Rr~ace LJ
New Construction LJ Alterations LJ
ChlmneyLJ Misc.__
8. PROPERTY AREA OR ACRES
Sq.A.
FOR ADMINISTRATIVE USE
- SETBACKS: Required
Actual
Front
-
Sido
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET r. Ii)
USE OF BUILDING K.t 1\ Vvl ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUcnON: I II III IV V
Occupancy Group A BEl H R M
DivIsion 1234
Clty:
Permit Fee ................................... $
\]4. '1'5
Plan Checking Fee ......................... $
State Surcharge ............................. $
I. ~5"
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Check If
Deferred
Subtotal............................... $
This Aplication Becomes Your Building Permit When Approved,
By
Date
Certificate of Occupancy
Issued
City Planner
....
:;--
I
.60
q 1. White
2 Pink
<~3. Yellow
PIle
CIty
Applicant
BUILDI_JlllFORMAllON
11. SIZE OF S~RE
- -, (Doplh)
12. NO. OF STORIES
13. TYPE OF CONSTRIl"TlON
't./?-:,- 'faD-+,
14. FLOOR AREA APPORTIONMENT USE
MATERIAL FILED WITH APPUCATlON
SOIL TESTS a ENERGV DATA a
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS LJ SETS
SURVEY
PLOT PLAN
a COPIES
a
Amount Brought Forward .... .............. $
Par1<SUpportFee ........................... $
SAC ......................................... $
CollectiveStreetFee ....................... $
SewerTap ................................... $
L.iceneeCheckF.. ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
CJ Sewer & Water Connection Fee ........... $
LJ WaterTower Fee ........................... $
Watel"Tap ................,.................. $
Other ......................................... $
Other ......................................... $
Total Due .............................. $~. 00
Paid '7G. 00 RecelDlNo..~~Otl'-l
. Date "7~nO BV~' 1
ThIs IS to certify that the request in the above application and ~ ~.. ..' ~Ing docUlTl&fts Is In _~_~ ......... with the CIty Zoning I and may proceed as ed This docwnent when
signed By the CIty Planner constitutes a temporary Certificate of Zonfng compliance and allows construction to commence. Before OCCl.pBllCy. a CertJficate parley must be IsSued
Date Special Concitlons if any
24 HOLK notice for all inspections 447.4230 9:00a.m. -10:00 a.m,