HomeMy WebLinkAboutBuilding Permit 00-0652
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL~D
DATE TIME
~ Q:3o
ADDRESS lCot"1~ NortRwood Rd
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o - G,.~7_
o FOOTING
o FOUNDATION
o FRAMING r@
~SULATION
'------<llV'INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~.p.
,K'a-vI
,
.....,
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(II~
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l WORK SATISFACTORY, PROCEED
o 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 & SAFETYt
INSNOTl
~\
OA TE RECEIVED
CITY OF PRIOR LAKE
~ BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'ljal/aO-
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
\ '-'.1:1.' N n-r~ I A rrr.........J
3. LEGAL DESCRIPTION
LOT '1 Cf BLOCK
ADDITION ~r~('Ool
1. DATE
'1 Ja1 Jun
, I ,
OJ"J"1"")..n)
PID a\"- \LlI-NO-()
4. OWN~ ~ame), ;:j) (Address)
~'-:>2dr...I!J. ~ 1/Jt/1 /I ~/")
5. ARCHITECT (Name) ('" -' (Add~eS~)
(Tel. No.)
4-47-.7,%%'5
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
g..~
SepticCl
Addition [I
Deck [I
Finish Attic [I
./
Re-roofin~ Porch [I
Rs-siding [I I 'finish Basement [I
7. TYPE OF WORK
New Construction [I
Fireplace [I
Alterations 0
t. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. -OO~ 06S 0
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 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
build~ .9fficial can re~s ~t tor just ca~. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x,~~~~ . 7-';;7-~
, ... . SignltUl'e license No. Oll.
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. ~
Park Support Fee ........................... ~
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ...........................~,
- SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING -:"'J.
yn -">
Mj(~
TYPE OF CONSTRUCTION: , 11 III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
f1Lj,'lS""
Permit Fee ................................... ft.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .................. ..................... $
Plumbing Permit Fee ....................... $
1 , <;lS"'
Mechanical Permit Fee ..................... ~
Sewer & Water Permit ...................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
$
Water Tap ................................... $-
Builder's Deposit ............................ $
Other ......................................... $
4'0101 Due .............................. $ "l C-.. OU
Paid 1 b eXl Receipt No.~ ""0 '4-'
Issued . - ~O ~
. Date 7/Q1Ln By {~ -
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinancJ' and may proceed as 'ested. This document when
signed by the City Planner constitutes a temporary Certificate ot Zoning compliance and allows construction to commence. Before occupancy, a Certificate of c upancy must be issued.
Gas Fireplace Permit ....................... $
~1~~li<ktiOil\ilJl,m's Y'l'r puildlng penmpt W n proved.
~rrJV\m_Date
Certificate of Occupancy
24 hour notice for all inspections (952) 447.9850
Special Conditions d any
City Planner
Date