HomeMy WebLinkAboutBuilding Permit 00-0384
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/Ct-/o 0
CONTR.
OWNER
DATE TIME
PERMIT NO.
(J7) -OS 84-
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION fK))
~FINAL '<'001" l.Bf
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.
cf~
j WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ALL 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
----.- --~'_._--"_._._.."---,,_.. ,.~._.._-_.".._.-.,-,.."_._----- --."..----......-
.-.-....'.-....-.-..-...-----..."
~1
D,ATE "l"CEIVED
c:;
1. White
2. Pink
3. Yellow
File
City
Applicant
11.-,
CITY OF PRIOR LAKE
BUILDING PERMIT,
. . ~ _ TEMPORARY CERTIFICATE OF
.. .. CIlUU ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Permit No.(J()- O?J<4
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ID~ESS
3. LEGAL DESCRIPTION
\d.
1. DATE
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
ADDITION
~ra...
Plo
QS- 30Q - ~l-O
12. NO. OF STORIES
LOT
~
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
/Jhjf
6'~/M<5
/:ttJ"/
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
New Construction (J
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I 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
and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
is permit st e. rthe ore, I hereby agree that the city offici a designee may enter upon the property to pertorm e insp ions.
6'1- q O'C
License No.
x
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS L:I PERCOLATION TESTS L:I
USE OF BUILDING -f 0 ~ A1!.
PLANS & SPECS L:I
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
"74.7<:5
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I. a<;
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ................ .... .... .... ....... $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
~otal Due [j?'........................ $
Paid b. Receipt No.
C/O
Gas Fireplace Permit ....................... $
~i e Y ,Building ~:t~I'lf~to
Issued
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdinan and may proceed
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate
City Planner
Dale
SpecJaI Conditions if any
24 hour notice for all inspections (952) 447.9850