HomeMy WebLinkAboutBuilding Permit 00-0381
DATE nME
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CONTR. g C;S I
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA,~IN~ A\'\T~T....
,..a' -1 ~1~
A---<'. ~o<;.<, 1/.2 ~
(0< WAIM 'fl..v C ~~ 4.-J,.
,
~RKSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING
Inspector:
~"
+
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY/
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CITY OF PRIOR LAKE
BUILDING PERMIT. -
TEMPORARY CERTIFICATE OF ::Y q~;)
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
jeRNOPt--Ptj
. S5;"O&.S-
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing)\ Porch [j
New Construction ('J Alterations 0 Addition 0 Finish Attic 0 Re-siding)d"'. FiniS/~Basement 0
Chimney 0 Misc. . ~ M---
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 men' e party a d t all construction will conform to all existing state and locallaw$ and will proceed in accordance with submitted plans. I am aware that the
building offi . oke it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to ~ needed inspections.
)IJ "",""No. r{)~~~:-()O
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 ........................... It
Water Tap ................................... !t
Builder's Deposit ............................ It
Other ......................................... It
Total Due .............................. L/."5"(). 75....
Paid /5l).75:" Receipt No. ~"7~ f-
Date By
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 as requested. This document when
signed by the City Planner consmutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
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DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DA"L I.
Sp.-Z-/(I()
2. SITE ADDRESS /,j,lnr
.,-r7.:J I.3t-VGBI,leO
71<? .
12/
3. LEGAL DESCRIPTION
LOT 3 BLOCK 5 PID ~6- aIO~()4-.3-o
ADDITION J:::NOf3 1-1/ U-'
4. OWNER (Name) J (Address) (Tel. No.)
77)11 /I e.e;
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
6I#I07J7JfII6S/
/717 ~~71f .cr.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
eB f/L
PERMIT VALUATION
z ~ClV ~ cl7J
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ........ ..................... $
State Surcharge ............................. $
Penalty ............................... ........ $
Jt/-C1. s ()
J.2E)
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $'
This
By
.............$
ildlng Pennfi ~ Lp_v.1F?r.
Date "ftW ()
I 1/
Issued
City Planner
Date
I. White
2. Pink
3. Yellow
File
City
Applicant
() 6. 0321-
BUILDING ,IHFORMA TION
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
SEATS
16. PROJECT COSTNALUE
17. COMPLETION OATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
$
24 hour notice for all inspections (952) 447.9850
Special Conditions n any