HomeMy WebLinkAboutBuilding Permit 00-0611
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1(,457
Fivt.. ~Mrhs
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
P YOUNDA TION
&"fRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: TLt ~
lJ
k~ ~ h-
I -"
~...{~ -~
L
fS l~fr>> TIM~
I-C./I
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY, PROCEED
10 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~, Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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DA T~ I;U:::r.F1V..EQ.
'I' /1.{)O
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yel10w
File
City
Applicant
Permit No. ro tJ& II
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12SIT'&Dri~7 -Hvc.. ~<A.wl-<s Ave S 6.
(Name) "In ^ Rf1~~~ii1~A1f~~u, me.
ST. LOUIS PARK, MN 554'16
Tn .u.1J.OA.1^"'S
7. TYPE OF WORK .j, Fireplace 0 Septic'tt-~ Deck 0 Re-roofing' Porch 0 SEATS
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PR9J~Os.lLY ~UE
Chimney LI Misc. (o~
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. CULVERT :::'IL~ -;7. C;UM~LETION DATE
Sq. Ft. Width Depth Yes No ~ ~vS
1 hereby certify that~ha~f ished 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 m13tioned rty 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 Ai n r ttl~ermit for just cause. Furthermore, I hereby agree that the citr official or a designee may enter upon the property to pertorm needed inspectIons.
X (', ' A___ ICJ~O '7-/4-CO
- " j Signature License No. Date-
3. LEGAL DESCRIPTION
LOT
BLOCK
ADDITION
4. OWNER
\Jct(!11
5. ARCHITECT
(Name)
Weyr~\Vth
(Name)
6. BUILDER
1. DATE
r-lCc-oc)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
/l!.2$p
PID 2.~ - 183. O/~' / I
I
(Address) (Tel. No.) I
IGt/SI f;vc. U4W)-!5b5~q0..~/~K>.<(m
I
I
12. NO, OF STORIES
13-?fPE OF CONSTRUCTION
l'\OO.t ,V> lj
14, FLOOR AREAl\PPORTIONMENT USE
(Address)
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/ZU,.,/~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.................. ..................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS [) PERCOLATION TESTS [)
Side
Side
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
7, 57FV r (/V'
PLOT PLAN
[)
S U
City:
Amount Brought Forward .................. <t
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... ................... $
Sewer Tap ................................... $
"
Pressure Reducer .......................... $
Meter Hom ................................... ~
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
1"_ 1~
1_7.~
Gas Fireplace ennit f $
ThIS A Beco ~s;iij;,~~.~.err""whenApJlfOVed
By J Date "7-,'1. cre--
CertIficate of occupalcy .
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ --J t;. .eI"
Paid 7 r" ,d () Receipt Np., ~ 7 r'1 p-
Issued Date 7, /9.Ul/ BY~/L
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certiflca of Occupancy must be issued.
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850