HomeMy WebLinkAboutBuilding Permit 00-0391
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/~98&'
SCHEDULED 1/?..tJ/(JI A,j,
'oewl f (~ 4V sui
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() () - ()39 I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
y( FINAL ~p
/b SITE INSPECTION
o PLUMBING RI
(fJ 0 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 GASLlNE AIR TST
o
COMMENTS:
r
~~
'114 WORK SATISFACTORY, PROCEED
b' CORRECT ACTION AND PROCEED
o CORRECT WO~ 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!
INSNOTJ
J3.F
~~
12A TI= RI=r.E.IYE.Q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
S'jdY/ao
Permit No.(')()- (ffiL
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
I'SA:;4' 00
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(H.ight) (Width) (Depth)
2. SITE ADDRE~"
lbq~b
3. LEGAL DESCRIPTION
II
[\e.U) ~ +-}~
I'MJ
PI~ .Q\i- \33- ()3(,-()
~.cw-i 0().. l..oJt.o _ 171Lu'>>~ -h- ,
\-'" ..3
(Address)
Sc-"-fDeVe.. {IoHO
'Pno,
L-, Ite.
12. NO. OF STORIES
ADDITION
11;n
.-
BLOCK
~
r "11'1-
I~
LOT
'3. TYPE OF CONSTRUCTION
5. ARCHITECT
(Name)
(\'\{'?
(Name)
(Address)
(Tel. No.)
{)cw\++
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
4. OWNER
6. BUILDER
(Name)
(Address)
447)~~"io
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~fm0~
7. TYPE OF WORK!
{-(gj~(S ~ePliC "L.-! ~ ~~"
Finish Attic 0
I\. ~ ) 51-. S l..t '
Re~roofin~~;~ Porch 0
Re.siding 0 Fmish Basement t':I
SEATS
New Construction 0 ~~ration.le_. .. t"ddition 0
ChimneyD Misc. ~
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No ') ~ ;) 1 - 0 0
I hereby certify that I have fumished 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 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~UI'ding Offi~~ this Mi:L:.cause. Furthermore, I hereby agree that the C::/,;;ii' ~ r:lir;e 2ay enter upon the property to perto:s ::~ed4n~PO:rs,
Signature license No. Date
16. PROJECT COSTNALUE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS " ENERGY DATA "
PILING LOGS " PERCOLATION TESTS "
PLANS & SPECS " SETS
SURVEY " COPIES
PLOT PLAN "
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
1~-" ivJ e
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F H , M R S U
Permit Fee ..........~i~~~~~...l...~...~..~... $ 'ILl. is"
City'
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... ................... $
Sewer Tap ....................................;:
Plan Check Fee ............................. $
Stete Surcherge ............................. $___ I. dO::;
Penalty ....................................... $
$
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn... .... ............. ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Penn
Water Tap ................................... $
Builder's Deposit ............................ $';
Other ......................................... $
~Tota' Due .............................. $ 'if-, QU_
Paid '16.0'0 Receipt No. :'J'll-f16
Issued
Date s1 aLl J on By r ~ )
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinance' and may proceed as 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 of pancy must be issued.
.
m s our Building Permit ~n.;srqrrfv~.
Date f(N
I
Certificate of Occupancy
C~y Planner
Date
Spec~1 Conditions if any
24 hour notice for all inspections (952) 447-9850