HomeMy WebLinkAboutBuilding Permit 00-0402
DATE TIME
CITY OF PRIOR LAKE I f (j /rflJ'?
INSPECTION NOTICE ~CHEDllLED ~.J' o-eJ
ADDRESS 'J Tl 61 C~ S,-l-, ~F'
OWNER
CONTR.
PHONE NO.
PERMIT NO. ern - n <-((j ri
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING~ 0 WATER HOOKUP
~NSULATI 0 SEWER HOOKUP
FINAL . 0 PLUMBING FINAL
o ITE INSPE TlO 0 MECH FINAL
COMMENTS: ~
~ . -1~l-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
~.L d~
~r'
~
t.J'
n _
)
I~
I. WORK SATISFACTORY, PROCEED
(0' CORRECT ACTION AND PROCEED
o CORRECT WOR~' C L FOR REINSPECTION BEFORE COVERING
Inspector: (Owner/contr:
, /
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
,.--,..-.",.-- ._-,_.--~,.._._.- ---....,..-...... "_.._.__._--_.,-,..~.- .--_.---
--
7. TYPE OF WORK Fireplace 0 .LIJ .".UW~ Deck 0 '-- Rs-roofing~..::-> Porch 0
New Construction 0 ~ Alterations ,0 Addition p. OFj1iSh f'!.!!c 0 F-e-siding 0 Finish Basement 0
ChimneyLl Misc. It?nA,,q fUl (~ !:MC& ^~ tl.ru"" -I; ~,,~
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I 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 0 ici Cfn rev077J Pft"Yit for~' t cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x(J,. ~J'Ll&A 0 <!::::. 0 c::,- 2<::- 6?'\
( (,.. Signature ' License No. - Date
DATE RECEiVED CITY OF PRIOR LAKE
BUILDING PERMIT,
. TEMPORARY CERTIFICATE OF
a, am 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)
IS~;ES_ em
SE-
PID ;)I\-ri1Cr-()SC1-0
~\
12. SITE ADDRESS 6' 7 to I
C!. rOSsQ'1cf..,rq
<~+
3. LEGAL DESCRIPTION
~ ~ BLOCK
ADDITION (' OA rrU ('{l. \
(Name)
(j ( 1Yl.Q/
(Name)
LOT
3
e1 D,lolV' \ &1-
(Address)
,~/I"'YL.R
(Address)
(Tel. No.)
q~Z- </<(7- 7~SO
(Tei. No,)
14. OWN~d)
15. ARCHiTECT
6. BUILDER
(NIiIli4A ltUUnNU Ill; t{J<;l~I!ibU'lU, U'lU.
4100 EXCELSIOR BLVD.
ST. LOUIS PARK, MN 55416
(Tel. No.)
W(z- ~3- ~O<((o
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit NoIv,1- 640 C)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Deplh)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATP
16.~OJECT COSTNALU~
>T/).'~9nZ\
17. COMPLETlPN DAlE
Co(0C>
r
- SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLlCA TlON
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
.~ ~112.
. .
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
'1Ll.7S"
Plan Check Fee ............................. It
';):5
State Surcharge ............................. <t
Penally......... ...................... .... .... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Pennil ...................... .t
Gas Fireplace Permit ....................... $-
T~plieEfjon ~~~ v,l.Y.rJJlllil<U.!:'9 Permil &tA~f/t'
By~Date W
Certificate of Occupancy
SOIL TESTS
o ENERGY DATA
Ll
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY Ll
SETS
COPIES
PLOT PLAN
Ll
pa~~! ~~..................~~~i~;~O$ 374 ~ I
Issued W
. Dale ...,/ By {
This is to certify that the request in the above a~licalion and accompanying documents is in accordance with the City Zoning Ordinan and may proceed a ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 0 upancy must be issued.
24 hour notice for aU inspections 447-9850
Special Conditions ~ any
cny Planner
Date