HomeMy WebLinkAboutBuilding Permit 00-0315
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
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:
DATE TIME
rn.3ts-
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~
Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNon
~... ._-~._"-,.._.--......__.--
~1
g~TE RECEIVER
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AN9 UTILITY CONNECTION PERMIT
I ;~ q/(J(J
;:-- ,,-",
MAY
..
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT)S ISSUeD (Please Print or Type and sign at bottom)
12. s:; 4;o~rs
(ju,/Aur LoM
;:) BLOCK L/
ADDITION C t'A ffi ~ l-tJ I h
14. OWNER (Name) 11
~v:Y; / L/~", (JunlliW
ISo ARCHITECT (Name)
B. BUILDER' (Name)
!JC>r'<C11 fk IY
All
3. LEGAL DESCRIPTION
LOT
PID
~'yh AnD t...J
.;:)t;;'- 3 J'-/ - 0 33-0
(Address)
Jl4r;
(Address)
eL"sbvt L ~ ~?o) "1'10 4<tt9
(Tel. No.)
(Address)
(Tel. No.) ::\
(5"'1)
qttJ ~J W,AlE w~se,.", /AI 1?$.s. ~~
7. TYPE OF WORK
New Construction 0
Fireplace [j
Alterations 0
Septic D
Addition D
Deck 0
Finish Attic 0
Ae-roofing 0 Porch D
Re-SidingJ( Finish Basement 0
I. White
2. Pink
3. YelJow
File
City
Applicant
f-I
5 'I" i~
Permit No. 0 b
- ()3J.r:::
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(He;ghl) (W;dIh) (o.plh)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney D Misc.
lB. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. FI. Width Depth Yes No
I hereby certify tha 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 abov looed p arty and th~1 all co t . "Will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bui official can revo this pennit. . rthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X ~~~
Slijfiature /" Lk;ense No. 0aIe -,
17. COMPLETION OA fE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Pennit Fee ................................... $
'lLf. 7~
Amount Brought Forward .................. It
Park Support Fee ............. .............. If:
SAC ......................................... $
Collective Street Fee ............. .... ...... If:
Sewer Tap ...................................4:
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. 4::
Sewer & Water Connection Fee ........... 4::
Water Tower Fee ........................... It
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
pa;~ 76u~ 06............~~~,;;~o$ 7, ;~O ~
Date S;:/r't'l/ ern By I
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoningf>rdina~ce and may proceed s
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificat of
S U
City:
Plan Check Fee ............................. $
State Surcherge ............................. $ ) ~ ~
Penalty .......................... ......... .... $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
Gas
replace Pennit ....................... $
e~ ~rf3ui!Qing Pennit ~~P+f(d;
, !JlA\V'9 Date ~'1'J
Th
By
Certificate of Occupa cy
Issued
City Planner
Date
Special Conditions ~any
24 hour notice for all inspections 447-9850
$