HomeMy WebLinkAboutBuilding Permit 00-0361
a/:&r TIME
CITY OF PRIOR LAKE K
INSPECTION NOTICE SCHEDULED
ADDRESS 1~lq1 M../h Sf
OWNER CONTR.
PHONE NO. PERMIT NO. 0-3<"1
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~ INSULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
'd CW;t. hlt
WORK SATISFACTORY, PROCEED
o CORRECT A N AND PROCEED
o CORRECT CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 7-98 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
~t
DATE RECEIVED
~7~{/ .
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
';laJ; 0
I. White
2. Pink
3. Yellow
File
City
ApplicBDI
Permit No. 00. ()3 (p. /
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
/~/9/
n".,./#
~G.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT
BLOCK
PID Z5-001- iJzr-O
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction LJ
Fireplace 0 Septic 0 Deck 0
Alterations tJ Addition 0 Finish Attic 0
/!'/.A5S A SHI/IIGLES
Ae-roofing
Ae-siding 0
Porch 0
Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
~b
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
Sq. Ft.
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
the above mentioned property and that alt construction will conform to all existing stale and locallaw$ and will proceed in accordance with submitted plans. I am "aware that the
building official can revoke this permit for just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed Inspections.
X
Signature
license No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
USE OF BUILDING
~ Aj.e.
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REQ. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 2, $;l!/J. cI1J PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
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. ............. ..................... $
7cf. 7r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ............................... ........ $
Plumbing Permit Fee ....................... $
I.Z-~
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Sewer & Water Permit ...................... $
Gas Fireplace Permit .. .................... $
ing ~:,'::'it~h1Itfl/
/
Issued
Paid
By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin Ordin and may proceed equested. 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 Occupancy must be Issued.
CityPlannar
Date
Spacial Conditions if any
24 hour notice for all inspections 447-9850