HomeMy WebLinkAboutBuilding Permit 00-0444
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/4 3'8' ~
DATE TIME
SCHEDULED ~ ~
H6fvu.. ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
an -04LjQ
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTI
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 GAS LINE AIR TST
o
COMMENTS:
4 -'Uo (~ ~
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,Ji! WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~l
- ,
. Owner/Contr:
CALL ....7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
-.--------...---..-..-.-- ... '._-, -~_....,_._._-, "--'-"---' -..--..--.---.-
-.-.--.-..........--.-.----.
QATI=RI=(,,-.E.IYEQ.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
6l~ JCJ}J
1. White
2. Pink
3. Yellow
File
City
Applicanl
Permit No. 00- OLi44..
New Construction 0
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
1 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 above mentioned property and 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
building ~fficial can revok p~. for 'ust cause. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn ne~ed ~.p~ons.
X C~ . /_-,,- <:::.c::,
alure License No. o.te 1
I 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
/43 7dr;. I"/-. K' AWJr\'VL. Nb
'67s / ao
3. LEGAL DESCRIPTION
I
~I,..kt\
ADDITION
4. OWNEIJ
AlA",
5. ARCHITECT
(Name)
5<:;-, k-#
(Name) ,
;).. PID ~S-a.(,4~ () I {)-o
<to f'.kclY\l-h <::"'h..uyy t)r,Jc.~
(Address) (Tel. No.) (
/'(3'0;). Ii~~..... /L <l5<c-. :J-/<.;" ~
(Address) (Tel. No.)
LOT
BLOCK
Ar:!rJ 1)
8, BUILDER
(Name)
(Address)
(Tel. No.)
A (/t~
7. TYPE OF WORK
5L,..-k,-.(~
/<( '"? ~ a. ;::;\1.... ~ '/9 (, - d-/<;' '/
Fireplace LJ f. Septic LJ . LOeck LJ Re-roofingK Porch LJ
Alterations C1 Addition C1 Finish Attic C1 Re-siding C1 . ~inish Basement [j
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
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FilED WITH APPLICATION
Amount Brought Forward .................. It
ParK Support Fee ............. .... .... ...... 4:
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Horn ................ .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... !t
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $X. D'O
Paid '7LUV RaceiptNo.31C,;;J4
Issued ., _
Data h.~ By f~)
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 a 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 ccupancy must be issued.
SETBACKS: Required
Actual
Front
Back
Side
Side---
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING V f)"" ~} I.L
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
OM,ioo 1 2 3 4 '71..j.'lS
Permit Fee ................................... $
Plan Check Fee ............................. $
City:
State Surcharge ............................. $
Penalty ............................... ........ $
i. ;J,
Plumbing Permit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & WaterPennil ...................... $
...................... $
a Yo r Building Pann" 't'J~r/rovad.
~ Date ~W
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections (952) 447.9850
SOIL TESTS
[j ENERGY DATA
C'J
PILING LOGS LI PERCOLATION TESTS [j
PLANS & SPECS [j
SURVEY LJ
SETS
COPIES
PLOT PLAN
C'J