HomeMy WebLinkAboutBuilding Permit #00-0430
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS \4: LeA
-
~-GL'
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING @) 0 WATER HOOKUP
,[J)/'ISULATION 0 SEWER HOOKUP
~~NAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: (W
p~ V~ oy...
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TIME
If"'
O-q-so
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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)(JNORK SATISFACTORY. PROCEED
( 0 CORRECT ACTION AND PROCEED
:S::~O~ECT ~:OR REINS::::::::FORE COVERING
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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DATE RECEIVED CITY OF PRIOR LAKE
/' / /Y?l BUILDING PERMIT,
G d. ()u _ 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 ADDRESS
\LII'i(LI
1. DATE
bJeJou
I
K\)--\-o..-e~ s,+~* NE
3, LEGAL DESCRIPTION...J ..",MlIU!i'\
LOT ~,..J-;sO BLOCK T\I\M:J lIS ~ as-- c(30- O'i<l-C)
UYD ()SI
ADDITION
L White
2, Piok
3. Yellow
File
City
ApplicllDt
Permit No. (X) - d-I.lIl
BUILOING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12, NO, OF STORIES
13. TYPE OF CONSTRUCTION
4. OWNER..,.... (Name)
U t,rf'V
5, ARCHITECT (l'Iama)
W j?1t >>pq
f
(Address)
1'118'1
(Address)
RvtT1>/'
.
(Tel. No,) 14, FLOOR AREA APPORTIONMENT USE
.ST ~/l- ~'trI/,(}J; t
(Tel. No.)
6. BUILDER
7. TYPE OF WORK
New Construction 0
(Name)
(Address)
(Tel. No,)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJECT COSTNALUE
Chimney 0 Misc.
8, PROPERTY AREA OR ACRES 19, PROPERTY DIMENSIONS 110' CULVERT SIZE
Sq. Ft. Width Depth Yes No
, hereby certify that' have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for
the above menti d 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 official a revoke this permit fjust cause urthermore, , hereby agree that the city official or a designee may enter upon the property to perto'J'l needed inspections.
X ' t;.-l.-oO
LicensaNo. Date
- SETBACKS: Required
Actual
~
Fireplace CJ
Alterations 0
Septic Ll Deck Ll
Addition 0 Finish Attic 0
Re-roOfing~ Porch Ll
Re-siding C:I Finish Basement C:I
FOR ADMINISTRATIVE USE
BUILDING DEPARTMENT VALUATION
Front
Back
Side
Side
USE OF BUILDING
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .....,..,.........................,...... $
Collective Street Fee .... ................... $
Sewer Tap ...................................~,
.
~/~ If) g
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I 11 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
-,i--I.'S
City:
Permit Fee ................................... ~,
Plan Check Fee ......................... .... $
;J5:""
State Surcharge ............................. $
Penalty .......................... ..... ........ $
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PIUNG LOGS a PERCOLATION TESTS a
PLANS & SPECS 0
SURVEY a
PLOT PLAN a
SETS
COPIES
Pressure Reducer .......................... $
Plumbing Permit Fee .. ................. .... $
Mechanical Permit Fee ..................... It
Sewer & Water Permit ...................... It
Gas Fire ace Permit ...................... $
e Y r Building ~:1';it Wt;1'ilfh
Tll'
By
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ "r) (". OU
Paid '7 C-. 00 Receipl No, 31 {, I ~
Issued -
Date k fa IfTT1 BY~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdil~e and may proce s re ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifica of pancy must be issued.
24 hour notice for all inspections (952) 447-9850
Special Condllions it any
City Planner
Dale
Certificate of Occupancy
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