HomeMy WebLinkAboutBuilding Permit 00-0524
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE nile
SCHEDULED
~/~
ADDRESS
ltJzKo ~~wr'l
OWNER
CONTR.
PHONE NO.
PERMIT NO.
IJ -,)'1.J.{
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
;-~;E~OZ
COMMENTS:
~i~ ~ ~ ~ U_i9L9h<-,
~.( I9K ~'i~(~,
. '11
,/'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
''''''''''
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0/21/(.21
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE r~~'SO
1. DATE
k)L-.
(o-dl '00
tt:.(
A\l~ t/)~rd
3. LEGAL DESCRIPTION
/
"'112
/
1"/1/0/5 /-flu_ 2Nn
Te 1~-crS)
PID 2~-nq- OO/-U
LOT
BLOCK
ADDITION
4. OWNER
uS~
(Name)
\ A .Il. (Tel. No.1 4c?-
n-.JSo V'AuP}'l.ra CW+ I
(Tel. No.)
5. ARCHITECT
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
rmtlt o~uL
7. TYPE OF WORK
New Construction LI
Fireplace 0
Alterations 0
Septic 0
Addition [j
Deck 0
Finish Attic CJ
Re-rOOfing~ Porch CJ
Re-siding CJ Finish Basement CJ
J'"
I. White
2. Pink
3. Yellow
File
City
Applicant
5- '1"O~)
Permit No.
QD-05z4-
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
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS f10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that t have fumished in.'v., ,.a..v., on this application which is to the best of my knowledge true and correct. J also certify that I am the owner or authorized agent for
the above menti eel 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
:uilding official c revoke this \rm\ fO~. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertor ~~ed~~OO
V - ^-1 SiQillftJre Ucense No. om.
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
USE OF BUILDING
.ec::, ;Yf IC-
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 2,57J{J. PLOT PLAN 0
Amount Brought Forward .................. <t
Park Support Fee ........................... $
SAC ........................................._If:
Collective Street Fee ....................... t
Sewer Tap ................................... t
$
Pressure Reducer .......................... ~
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $~. UD
Paid Receipt No.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
--;4. 7)
City:
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $=
Penalty ....................................... $
Plumbing Permit Fee ....................... $
I. z.. \
Mechanical Permit Fee ......... ......... ... $
Sewer & Water Permit ...................... $
This
By
Issued
Date
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 as 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.
By
City Planner
Date
Special Conditions if any
24 hour notice for all inspections (952) 447.9850