HomeMy WebLinkAboutBuilding Permit 00-0287
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/fr;()7:;2.
~
cJ
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION {P)
FINAL
~ SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~
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DATE TIME
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A. (;
CXJ-~7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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--
-
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?l WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~LL FOR REINSPECTION BEFORE COVERING
Inspector: -1A- I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
---'--"'--'~-' ._---~,._-------_._---_._---_..~-
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DATE RECEIVFQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
APR .1 am
PermitNo6D-o~<jL
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 L. rAn I I ,
((,,€J{ 2-:t="'1i'LA ("_~,oiL ~ :..y R..L:'-' LM<< MA/
3. LEGAL DESCRI~IO~ J ,
LOT N P () LIi.J4{oCK ~ P~PID ~ -0<:(6-031-6
f Lo k..p 5'.v1 IJ~ pn f-IL
~11\~ {Nam&!.
1. OAT!!
4 -28-200::'
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Address)
RIO"~f~
(Tel. No.)
13rYPE OF (,bNsTRUCTION
~-~ ~J.. /
14. FLOOR AREA APPORTIONMENT USE
ADDITION
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER:
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~~ 0....-
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPj=RTY AREA OR ACRES
Sq. Ft. II
] h b ertifythat 1 have
th a mentionE j prop
bui i ff ia n 3vok
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing)(, Porch 0
Re-siding 0 / ~ish Basement 0
SEATS
16. PROJECT COSTNALUE
x
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
mished iL ,;~..,.", "u~ this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for
nd that construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
4- 7_p,-70<0o
License No. 0.. -
17. COMPLETION DA1'E
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
D ENERGY DATA
D
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
USE OF BUILDING
SURVEY
PLOT PLAN
o COPIES
D
TYPE OF CONSTRUCllON: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 "'I""'1U""-
Permit Fee ................................... $~ S
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ..................... .... .... $
State Surcharge .............................11:.
a:<>
Penalty ....................................... cr
Certificate of Occupancy
Builder's Deposit ............................ $
Other ......................................... $
~Total Due (jO........................ $ '7 b. cro
Paid 76 . Receipt No.2 '{ 3(, 7
Issued ./.1 ~
Date 9/riJi(//TO By /,
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni~ Ordina~ and may proceed rrrr: uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertifICate ct Occupancy must be issued.
.
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water PermIt ...................... 4:
es 0 B~ilding permi~nJ,.np"?vein
ate -+/;5, I< r
CityPJanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850