HomeMy WebLinkAboutBuilding Permit 00-0342
CITY OF PRIOR LAKE
INS~ECTlON NOTICE
SCHEDULED
DATE TIME
~ /0:50
ADDRESS
577 s
&&HIAkMKJ ~, Je;
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATIO(pN
o FRAMING
o INSULATIO
s7FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ee - ~..;=-
~ - 3'12.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
,,0 FIREPLACE FINAL
o GASLlNE AIR TST
o
<-...,,"""..,,-
-~
~~
,.:"""..",
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MAY I I 2000
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
5775 l3/teertwD 00
I~;;
'(. '/-M,...,
PtJSO
.dc/-
,....,. c:;...
3. LEGAL DESCRIPTION
LOT
7 "LOCK 5"
SAND POINT 2;.10
PIDZ5~205 -057-0
/fOnN.
ADDITION
4. OWNER (Name) (Address) (Tel. No.)
e,€/u ,er/VO 16,,) 4<J.:5, lofn
5. ARCHITECT (Name) (Address) (Tel. No.)
\,II0i:1t ((;r. ,"I Ll~, , t.N~9
6. BUILDER (Name) (Address) (Tel. No.)
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
Fireplace LI
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 00- 0'2/-/0>
BUILDING INFORMATION
". 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 DATE
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \'0. 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. 1 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
building official can revoke ~-.I..'. e-;:.:. fo;tjl ~.,." Furth.rmo'e, I h.,.by agree Ihat the city official 0' a deslgn.e may enler upon the property to pertorm needed Inspections.
X .r-, r <;' MNv '1 '2llnn
- Signature . __ License No. /Cfde
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .... ...... $
Sewer Tap ................................... $
.
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING ~ M Q
r
TYPE OF CONSTRUCTION: I 11 III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
R S U
City:
74-, 76"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
1.25
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Plumbing Permit Fee ....................... !I:
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... 0;:
Meter Hom ................................... 'l:
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
TGB~.'SS~FirePlac.eonPlermit ............ .,...,....I4a\.p...$:".tsh'$eir7l'r-:r..ed. Water Tap ................................... $
I )(j Builder's Deposit ............................ $
Other ......................................... 'l:
C.rtlfleet. of Occupancy pald~ru~O.................~~;~;~;~o$ 51 g~ T
Issued - --
Th~ is to certify that the cequest In the above application and accompanying documents is in acco,dance with Ih. c~:;oni~:Lr::.d may P'~d ~!sted. Th~ document when
s~ned by Ihe City Planner constitutes a tempo,a", Certifieel. of Zoning compliance and allows construction to commenee. B.for. occup.ncy, a Certificate ~~:pancy must be issued.
24 hour notice for aU inspections 447-9850
Special Conditions it any
City Planner
Date
.---r-~-----_.------~,.._,.,.