HomeMy WebLinkAboutBuilding Permit 00-0508
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
'!:)7 :) '--1,
OWNER
PHONE NO.
o FOOTING
o FDUNDA TlON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE nilE
SCHEDULED ~~~~3
G~~^ J~,
CONTR.
PERMIT NO.
JC>t0 - ~
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
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: AA
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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QATF f:lFC':FIVEQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
b / 9~/u'o
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED {Please Print or Type and sign at bottom}
2. SITE ADDRESS <":"J J
F)~ ~L1 ~ ~ N)r\llJ~J'l~^ ~ Nt
3. LEGAL DESCRIPTION
'?( BLOCK L.j
S(~ ~"(\k- al'-OL
1. DATE
~ ld-Q,/oo
LOT
PID QS- 0108"-036-0
MAA~
ADDITION
4. OWNER
(Name)
\\411 L
(Name)
(Address)
()'lc.-ntTlJ~
(Address)
(Tel. No.)
'-I-L/~-()7(J{J
(Tel. No.)
5. ARCHITECT
6. BUILDER
(Name) (Address) (Tel. No.)
/"ItiJc.e ~t.J.iA . 3{$'ZJ L~J~f 'j 'fCjJ-3JY;;)
.v ~c~n~., /
Deck Ll As-roofin Porch a
Finish Attic 0 Rs-siding inish Basement a
7. TYPE OF WORK
New Construction 0
Fireplace CI
Alterations 0
Septic 0
Addition 0
I
f ~ 1 White
C. 2. Pink
../ 3. Yellow
tI ,;;'W
Permit No. cO -o~-oY
File
City
Applicanl
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
OCCUPANTS
SEATF
16. PROJECT COSTNALUE
Chimney a Misc.
8. PROPERTY AREA OR ACRES \90 PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
1 hereby certify that 1 have furnished infonnation 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 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 ~ c.!.p !e~~.tI)if penn~s~ cause. Further~re, I hereby agree that the city official or a designee may enter upon the property to p".( onn needed insp~ions.
X f rl7~ ~'4VM{).t'\./ .0-..::),:J--a;>
Signature license No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING -~ wt--P-
,
TYPE OF CONSTRUCTION: I II 111 IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Pennit Fee ................................... $
V
R S U
ryLJ , '1 S-
City:
Plan Checl< Fee ............................. $
State Surcharge ............................. $
Penally ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..... ................ $
I.~S"
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY LJ
PLOT PLAN 0
SETS
COPIES
Pressure Reducer .......................... !l:
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... <\'.
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ry". toO
Paid 7 b . (JV Receip1 N~. \'~ '1 to-a
Date l... {[7..a./rm By WV
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning O~inance And may proceed as'~uested. 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 ~upancy must be issued.
Sewer & Water Pennit ...................... $.
es our widing pennityhe APl10ved
Date la :z?lo I C-z.J
,,-
Certificate of Occupancy
Issued
24 hour notice for all inspections (952) 447-9850
Special Conditions ~ any
cny Planner
Dale
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