HomeMy WebLinkAboutBuilding Permit 00-0473
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
~ Jt.T-
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SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
00 -0473
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~.s- GASLlNE AI~ TST
o MECH FINAL 'lJj) r- $/ QI Ai 4-
COMMENTS:(/,} Ptd- I~ ~ ~
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o WORK SATISFACTORY, PROCEED
)( CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
W:h
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
------....-.-'.'--.-.. ...........,.,--.-.-....--....---.---.... ._...~- '..
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
16S03 Ft-cu\U.\(\ \,t'l'\ I
3. LEGAL DESCRIPTION
LOT
3 BLOCK
~m'''O)v-ct I ~ "
(Name) (Address)
P,vc/<k~7 /t l,'rl "3 F~.nv/((,~_
8~~
ADDITION
4. OWNER
1J.v71,,, "<-I
5. ARCHITECT I
6. BUILDER
QATF RF"FIVF~ CITY OF PRIOR LAKE
/ 0 BUILDING PERMIT,
b I ~ 0[) TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
AppliCllDt
Permit No./rQ -047.3..-
1. DATE
f, II:), /00
,
BUILDING "MATION
11. SIZE OF STRl..JC11mE
(Height) (Widlfi)- (Depth)
:::'E
I
~f'Ol
12. NO. OF STORIES
PID as" - 0012:,- 003-0
At)\J~
13. TYPE OF CONSTRUCTION
(Name)
~ ,-reI. No.)
th, r
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
I
I
(Tel. No) W....,;.17'10j
S. ~ ( jOf'-' l<;- R:,. I1fJJ ~:r-,j!?<J
DeckLJ
Finish Attic LJ
(Name)
(Address)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
fyJ( ~ t'o r<-' <;: I
7. TYPE OF WORK
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Fl. Width Depth Yes No
I hereby certify that I have furnished 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 ab~ve entioned P~d 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 cial can revet ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
c:"" ~- /. -'(J
X :/A/-."""";;'-- J"'{"A~ _ r... f' /:;J.r- c<
- ~ S~a1ure License No. Dale
New Construction 0
"'J, ~ J;;/.
SEATS
16. PROJECT COSTNALUE
Fireplace 0
Alterations LJ
Septic 0
Addition LJ
Fie-roofing 0 Porch 0
Re.sidi~ Finish Basement LJ
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Fronl
- BUILDING DEPARTMENT VALUATION
Side
USE OF BUILDING
11 0.>. wll(
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
'7'-1.'1S'
Permit Fee ................................... $
City:
A{nount Brought Forward .................. $
Park Support Fee ................. .... ...... $
SAC .....c................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ......................... .... $
State Surcharge ............................. $
Penalty ....................................:_ $
I. ;)~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer ......................... ,t
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
es 0 Building Permit 'he~~~
. Date _OfL~/J
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Tolal DU'V'o.......................... $ '7(....<-V
Paid '7 ". Receipt No. )'1, 1 "f, 3
Issued J
Date blJ~/(J/) By ~^
ThIS IS to certify lhatlhe request In the above application and accompanYing documents IS In accordance With the City ZOOlng ~OrdlnaJfce and may proceed r u~ted ThiS document when
signed by the City Planner constitUtes a temporary Certificate of ZOOlng compliance and allows construction to commence Before occupancy, a Certificate upancy must be ISSued.
Certificate of Occupancy
CilyPlanner
Date
Special Conditions n any
24 hour notice for all inspections (952) 447-9850