HomeMy WebLinkAboutBuilding Permit 00-0190
DATE TIME
CITY OF PRIOR LAKE 4-1l-yJ' tr
INSPEC'fION NOTICE SCHEDULED
ADDRESS /1;/2 q ~ Rd
OWNER CONTR.
PHONE NO. PERMIT NO. tJ-ICf,o
o FOOTING
o FOUNDATION
o FRAMING
~SULATION k
FINAL fA.
SITE INSPECTION') ,
COMMENTS: /Wv/,
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Inspector:
CALL 447-9Sho FOR TH
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~;}AL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
-
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INSPECTION BEFORE COVERING
Owner/Contr:
NEXT INSPECTION 24 HOURS IN ADVANCE.
'ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12 SITE ADDRESS It:;/ J 9 mar? i rOtA- Rd
1. DATE
f;/tj/oo
?lSD
3. LEGAL DESCRIPTION
.3
PID 2.<: -()C;~ <-i)
LOT
BLOCK
K/JPPS 6fl1/
(Mdress}
L(Jmh fScmu.
(Address)
{)('
(Tel. No.)
fJb!W--~
(Tel. No.)
ADDITION
14. OWNER
15. ARCHITECT
6. BUILDER
(Name)
hordor,
(Name)
(Name)
(Address) (Tel. No.)
9509 1<1'1dfl/t-~,['(.4 a/~f?f-fr;f(O
f(evoo{ ~Yi{.tJv
7. TYPE OF WORK
DeckCl
Finish Attic CI
Re-roofing g' Porch CI
Re-siding 0 Finish Basement 0
New Construction 0
Fireplace CI
Alterations 0
SepticCl
Addition 0
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.l5D - 0 I.!l.l2
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. ~ OF CONSTRUf{ION
1'-<.. {' 0 Q:Jr
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
$ f, f 00
17. COMPLETION DATE
Chimney 0 Mise
18. 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 that aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding offjcial cal~~t cause. Furthermore, I hereby agree that the::J oicit;a;;eig{je may enter upon the property to perform ntl c/~ti~s.
Signature license No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
USE OF BUILDING
Jet::-. S IT /~ SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
zS7fV_rJ))
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
~f75:
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
/.2-r
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
::lJkf~~;,~i~~i:I;~~7J.
Certificate of Occupanr -
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
$
:~:r;~~~.dO:::::::::::~~:~i~:::~: 3~;:f!f
Issued ~~
Date '/l) By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni~rdi ance and may pr s requested. 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.
City Planner
Date
Special Conditions ~any
24 hour notice for all inspections 447-9850