HomeMy WebLinkAboutBuilding Permit 00-0358
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 5 ,2.Y
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
.C} INSULATION~,
OO-FINAL V
o SITE INSPECTION
COMMENTS: ~;d."J
I h J../4
)
SCHEDULED
DATE
~
TIME
A-1
Con.~S
s...
CONTR.
PERMIT NO.
6 - 3SP.
o PLUMBING RI
o 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 GAS LINE AIR TST
o
~~
,
+-:J ~. )
/
~-
\61.,ORK SATISFACTORY, PROCEED
;;;~ORRECT ACTION AND PROCEED
:.::C::ECT WO~,OR REINS~::::::::FORE COVERING
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
. --~_."--_."'-'-'-'-~-~-'_.
INSNOTl
~~
'r'-:P~ AEGClVEQ;
";::- ,Ir" r
. CITY OF PRIOR LAKE
.. BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
MY I . imlZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. al1- f'l ~
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
1. DATE
f-/6 -&0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
SlJ-1f ~"-... Sf 5~
3. LEGAL DESCRIPTION
LOT \ d. RLOCK
ADDITION r "'N"'\.curri~ Wrmclo-v....
12. NO, OF STORIES
PID d.,~- o;2Cl-Olfi-O
13. TYPE OF CONSTRUCTION
4. OWNER
'f.......
5, ARCHITECT
(Name)
I.<r u.. ere.r
(Name)
(Address)
'i/?4 Co..d~ Sf'
(Addr.ss)
~fi
(Tel. No.)
1fc{7 -/ ]7p
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
>-........1.--.... c..-,.+.
t!3sr lJ~.'''-, p""" W,~
1f'f7 ~ IJ7~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
7. TYPE OF WORK
New Construction 0
Fireplace LI
Alterations LI
SepticLl
Addition LI
DeckLl
Finish Attic LI
Re-roofing LI Porch LI
Re-siding pi:. Finish Basement LI
SEATS
16. PROJECT COSTNALUE
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 thaI all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thallhe
building official can revo e this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
X ("'? ~ l6t's.....-.4.-tJD
Sig?"ure License No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
LI ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS LI SETS
USE OF BUILDING .r. A: / {2
r 0 '""--+-r -
TYPE OF CONSTRUCTION: 1 II ill IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 1"'1LJ *7-
Permit Fee ................................... $~ ~
SPACES REO,
SPACES ON PLAN
SURVEY
LI COPIES
PERMIT VALUATION
PLOT PLAN LI
City:
AmountBroughtForward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ........ ..................... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
J. dS-
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $ Water Tap ................................... $
ThBy4~9IcJ1.~~J,r,~I~ingDPaetnn. it'1?f;~,/Z;'J Bu;lders Depos;t ............................ $
r ~-/..!/..JCj Other......................................... $
Certn;cate of Occupancy pa;J7~u~..............~~;~;~;~O$A~t::3
Issued
Date ,'")///.,/Ol; ~y / J
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ~;;:;te and may pr r uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certific pancy must be issued.
CrtyPlanner
Date
Speciai Conditions n any
24 hour notice for all inspections 447-9850