HomeMy WebLinkAboutBuilding Permit 00-0636
CITY OF PRIOR LAKE
INSPECTION NOTICE L/ 95V SCHEDULED
L..{ G' /7 Cf/'(,J i -r fl, "':~
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
Y'-r- - rO~
DATE TIMe
q-lfNr:s
1t.1-
fYJ'-(o 3(0
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~~
-
1;::'\
f-7 /, J
, . - /
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~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: 1/!J1? q - / f:; - d) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUlREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
DATE RECEIVED CITY OF PRIOR LAKE
1.2A.Od BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Ml(&
q-I?
Permit No.-!)f) -<Xo3~
1. White
2. Pink
3. Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS ./I .o.e::-O ~./Pen ""
"t""7-..J ~Olf ,~/V~
1. DATE
7.2-/.00
~
I!: 2.-
BUILDING INfORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
5F~T 02-
BLOCK
PID .?5 .90Z-- 070 .0
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER
15. ARCHITECT
6. BUILDER
(Name) ____
-r72/a#1~
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0 Deck 0
Addition 0 Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
la. 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 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 th all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
b . ing 0 icial can r~ pflrmi ~just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pyn/1r needed inspections.
.~.. ~ 7~~~
I'" Signature License No. I Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING ~ R/JC.-
,
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS a
SURVEY 0
SETS
COPIES
?_,S7Jb .(/l/
PLOT PLAN
o
TYPE OF CONSTRUCllON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. 4:
Park Support Fee ........................... 4:
SAC ......................................... $
Collective Street Fee ....................... ~
Sewer Tap ...................................4:
$
Permit Fee ................................... $
14-.1~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .................. ..................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
1. z..r
Pressure Reducer ..........................4:
Sewer & Water Permit ...................... $
Meter Horn ....... .... ........................ $
Water Meter ................................. 4'
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... .'t.
Water Tap ................................... 't
Builder's Deposit ............................ $
Other ......................................... $~
Total Due .............................. $::7/n. 0 C)
Paid 1 '" . 0 0 Receipt No. 3A C> '.10
Date 1. 1.-1.0 t>
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proce
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certifiea
City Planner
Date
Special Conditions if any
24 hour notice for all inspections (952) 447-9850