HomeMy WebLinkAboutBuilding Permit 00-0610
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
y. 7'oU I4.T
ADDRESS
/ (p 0 S!, CHH !3 K::.I 0&6
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL Je..I>()~
/0' SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
00 .0(01 ()
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
...., .
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AWORK SATISFACTORY. PROCEED
I;; CORRECT ACTION AND PROCEED
o CORRECT w;}fK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: 91-1 Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANC~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
--~-'--'---""""~_."-------_"_"'____'_~_'____W'__._~"'_'________'___"'________
~~
pATF RFr.FIVFn CITY OF PRIOR LAKE
7./9.(;0 BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 06. Oflz /0
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
12. SITE A9DRESS II
I~O{}~(~a'mbn'~e.. CIl'Cle Sr-
1. DATE
,-/<1_cO
eJ
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
~
PRlo/t..
14 OWNER I"14r ttiV~l~n
15. ARCHITECT (Name)
6. BUILDER (Name)
12. NO. OF STORIES
LOT
BLOCK
PID 25-009'014-0
ADDITION
AtY!ES 2NO
(Address)
J~05'fr('4{Y1brl~e f~t 5e
(Address) -
BELA ROOFING & REMODELING. INC.
4100 ~llillJ;hjSlUR BLVD.
ST. LOUIS PARK, MN 55416
ill #0001050
(Tel. No.)
CrJ.- qL/I- :J,'),S-7
(Tel. No.)
13. TY)?f OF CONSTRUCTION
Ic..ool\'t'l~
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBEA OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WOAK Fireplace 0 Septic 0 Deck 0 Ae-roofing ~ Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Ae-siding 0 Finish Basement 0 16. PROJECT COSTNAJ;UE
Chimney 0 Misc. ~4" 5'6 .l!:!-
lB. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. F1. Width Deplh Ves No "3/!J Pc< y ~
I hereby certify that I have~U~'Shed' formation 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 abover;?J;i.o d props a at 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 0 ci re~ke s it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .. -. 1050 7-/tf-co
- . ./ , Signature License No. Date
SEATS
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.~-'" 'o/.IL
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
zr(/V
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H , M R S U
City:
Amount Brought Forward .................. <1'.
Park Support Fee ........................... <I'
SAC ......................................... .<1'.
Collective Street Fee ....................... It
Sewer Tap ................................... 'I:
.
Division 1 2 3 4
Permit Fee ................................... $
747s
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.z.r
Other ......................................... $_
Total Due .............................. $ 7(..00
Pa,d 1~.0 0 Rece~PI 3"7~"f..
Issued
Date 1./'1.cro By
ThiS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City Zomng 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 Certificate of Occupancy must be issued.
Iding Permit WJJ.e~ .m-o;,~
Date -/ ,.."
Pressure Reducer .......................... $
Meter Hom ................................... <I:
Water Meter ................................. ~
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ <I:
Sewer & Water Permit .. ................... $
CijyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850