HomeMy WebLinkAboutBuilding Permit 00-0449
DATE TIME
SCHEQULED ~ A!r'
GI f'.jO,\ (~~ Tmi I
CONTR. J
PERMIT NO. ,un - ()LI uQ
CITY OF PRIOR LAKE
INSPECTION NOTICE
55dLJ
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION '^
FINAL~\Ob ,.
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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o CORRECT
Owner/Contr:
E NEXT INSPECTION 24 HOURS IN ADVANCE.,
lNSNOTJ
~~
nATF RFr~ CITY OF PRIOR LAKE
/ . BUILDING PERMIT,
b '6/'00 TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No,
oo-04!f1
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12 SIT~D5~ L1 (a rv~ J \
3, LEGAL DESCRIPTION .;J
LOT ex ti ,-;)5' BLOCK __
r iAA'"\J.l~: C -")~
14. OWNER (Name) .... (Address) . (Tel. No.) _
b // Ml'Lh/h" 5'#n?~ ds<;,':I.... .y5l7-63,~~
", ::-r:-""-~ (Namet /1 ____ .(AddreSS) _ (Tel. NO')'/':l/~~";'-
'?ar'I".4-/,71-4 9v~~~ Lc., "'" /.(q/ /-E'#ii,..s;hh _ .4~?,~
(' ~~ER (NameI' ./ JA<Jdress) /MJ. 11), (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
-' (DeVtre.... V'T',e", ....P....... J3'u,-?
.... i', r OCCUPANTS
1. DATE
te/ ~ lUG
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIctth)
(Depth)
(l)'~ \(T..:\ \
ADDITION
PID
Yurko
~s- 08.7- Q\''If-() I
12. NO, OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Rs-roofing 0 Porch 0
Re-Sidin~ Finish Basement 0
SEATS
16, PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES
Sq. Ft.
I hereby
the abo
buildin
19, PROPERTY DIMENSIONS 110, CULVERT SIZE
Width Depth Yes No
rti~ 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
"iltioned property and that all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
can revokJihis permit.,fO,r jU~1 cause. Furthermore, f hereby agree that the city official or a designee may enter upon the property 10 perform nee)ied inspections.
~j L~/.-",o
'-"1f' Signature License No. Date
17, COMPLETION DATE
x
v
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS Cl SETS
SURVEY Cl COPIES
PLOT PLAN Cl
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING \I.u ^ !5:/J2
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
. Division 1 2 3 4 4 "7S-
Permit Fee ................................... $ "'7 .
City:
Amount Brought Forward .................. 4:
Park Support Fee ........................... <t
SAC ......................................... ~
Collective Street Fee .... ................... 4:
Sewer Tap ...................................4:
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ......... .... $
1.::1:5
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... ot
Meter Horn ........... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Y. u ElI'i1ding Perml1 Wl))'n ~oVfiT>
Date 'iY"'.J
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total DU"i.P<J'....................... $ '7 t-,. vu
Paid Ih. Receipt No, :5 7 t.. ..:s q
Issued tJ loV .
This is 10 certify that the request in the above applica1ion and accompanying documents is in accordance with the c~:;oning <irdin~nce and may pr::'d a~ . ~hiS document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of ~:~~ :ust be issued.
CityPJanner
Dale
Special Conditions if any
24 hour notice for all inspections (952) 447.9850