HomeMy WebLinkAboutBuilding Permit 00-0571
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/1.2A~() A- .j;
ADDRESS
"70 eo- 7)t"a,c;a~f Sf-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
P INSULA~I N C! 0 SEWER HOOKUP
.)'(FINAL 00 r 0 PLUMBING FINAL
o SITE IN PECTION 0 MECH FINAL
r'e-"\O,-, \'
COMMENTS:
IJ- S~J
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~K SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W ALL FOR REINSPECTION BEFORE COVERING
Inspector:
) Owner/Contr:
CALL 447-9850 FOR THE NI XT INSPECTION 24 HOURS IN ADVANCE,.
/NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
., . .~..,-~-_..'--'---_. - - -- ---_.........._.....~.._.
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nA TF 1:1I=r.F1VS,Q
CITY OF PRIOR LAKE~
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
1. White
2. Pink
3. Yellow
File
City
Applicant
on.051 (
1. DATE
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
40'l(J PLEA-SA-AJ r ST SE
3. LEGAL DESCRIPTION
5. ARCHITECT (Name)_
NOT It Pf''-/ '-"I fJL.t:
6. BUILDER (Name) (Address) (Tel. No.)
fllllElttcA",", 6~~Lbiil. la~<t7 N/('LLt:1 ,,~S', q5~-
CONT(tIl<-,O~. :j:;..,c.. BIf/UlJ;II'LL/i- ".,'" S~J)7 707-(,,"15,
7. TYPE OF WORK Fireplace CJ Septic 0 creek LJ Re-roofing)( Porch LJ
New Construction LJ Alterations LJ Addition LJ Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
Chimney tI Mise, " a aO, tt-o
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLE1ION DATE
Sq. Ft. J;J} 00 l> Width'l?1 Depth 19'1.7 Ves B 7 - 3/ - () 6
1 hereby certify that I have furnished infonnation on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for
the ve mentioned property that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
b din ffi' I n evo this e . st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
dO' 6'1 H'l .. '1-i.(,- 00
LOT
Ii/..
BLOCK
ADDITION
4, OWNER
k'Elnt
(Name)
~(l.A/'oI[)r
',Iollo
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
Le~ #/1'-
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A 8 E F HIM R
Division 1 2 3 4
Permit Fee ................................... <l:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty............................... ........ $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ......... ......... ... !f,
Sewer & WaterPennit ...................... !I::
7 - 5 - 0 0 BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height} (WIdth) (g,epthOI
I;::' .0;'::1. ...,.
12. NO. OF STORIES
PID l../f,:.& S /pli G~fY:}.J> I
~
13. TYPE OF CONSTRUCTION (~(O~
. . I.
14, FLOOR AREA APPORTIONMENT USE
S" I AI" Lt'" f'tl "'it... y
H-o", ~
(Address)
f'Ll:/lSfl ~7
PA'.il L~1. No,) tJ I a.
St. /ot.JI. $"S37~ '1-<17-'-/''11
J (Tel. No.)
51
(Address)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATP
License No.
0.10
FOR ADMINISTRATIVE USE
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA a
PILING LOGS tI PERCOLATION TESTS tI
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS a
SURVEY 0
SETS
COPIES
'2,s,-oo. eN
PLOT PLAN
tI
S U
71.1r
City:
Amount Brought Forward .................. $
Par1< Support Fee .... .... ................... ~
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
..-
J. z.)
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Gas Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ -
Total Due .............................. $~(d.d (,I
paidl~'CJ 0 RBeBIP!37.r1
Issued
Date 1~ 7~() (/ By
ThIS 1$ to certify that the request In the above applICation and accompanying documents IS In accordance With the City Zomng Ordinance and may proceed a equested 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.
City Planner
Date
Spec~1 Conditions if any
24 hour notice lor all inspections 447-9850