HomeMy WebLinkAboutBuilding Permit 00-0173
CITY OF PRIOR LAKE
INSPEC1'lON NOTICE
SCHEDULED
ADDRESS .1;43 B
Fa,"/r J ;>,W VI
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FDUNDA TION
o FRAMING ~
' ~SULATION
~ ~~NAL
o SITE INSPECTI
COMMENTS: U "J
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK~LL FOR REINSPECTION BEFORE COVERING
Inspector: IV' )i Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
~~
37;7~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1}:3f- 00
I /'i"' I
S/Jorf::{ IrQl,f.Ie
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 S4 '3 ~
'M';-/VCOd)
3. LEGAL DESCRIPTION
LOT 1 F e BLOCK
ADDITION P/1/&?/lNN Sm.e65'
PID ;?S; -03/- IJ OS~ 2.-
14. OWNER
15. ARCHITECT
6. BUILDER
F?~h1
t-e~ K
(Address)
. (Tel. No.)
41./0 . 50S U
(T.L No.)
(Name)
(Address)
(Address)
(T.L No.)
~c..j7- 27 yC
(Name)
LtlVl ~ ~y?f
o
u.f
Re-roofing ~ Porch 0
Ae-siding 0 Finish Basement CJ
7. TYPE OF WORK
New Construction LI
Septic 0
Addition 0
Deck 0
Finish Attic 0
Fireplace 0
Alterations 0
Chimney LJ Misc.
Is. PROPERTY AREA OR ACRES
Sq. Ft.
I hereby certify that I have furnish
the above mentioned property
building official revok th'
X
I, White
2. Pink
3, Yellow
File
City
Applicanl
Permit No. ff7J - (j /13
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(H.ight) (Wldth) (D.pth)
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
19, PROPERTY DIMENSIONS 110, CULVERT SIZE
Width Depth Yes No
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
h all construction witl conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
rm' or' st cau Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfo,pq needed inspections.
-1_ ~:V~O 0
License No. Datil
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ~
Water Tower Fee ........................... :t
Water Tap ................................... :t
Builder's Deposit ............................ ~
Other ......................................... ,It.
,
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z nrv _ f77../
USE OF BUILDING
-CO /:ItA:-
>
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
0"",100 1 2 3 4 74. 1r
Permit Fee ................................... $
Plan Check Fee .... ......................... $
City:
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/.2--5
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~::;;;j:::'t T~:~~'~~.~..~IlWh.
By r~ J'1" Oat. 6
1
Certificate of Occupancy
~pp'o"'d._ /
;:I r/OV
I MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LJ
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Total Du. .............................. ~ ""1". (J CJ
Paid ;/ t-% R.c.'ptNo 57/2.-&
Issued f
Oat. 3/~1 aV By ~
ThiS IS to certify that the request In the above application and accompanYing documents IS In accordance with the City Zomng Ordlr4nce and may proceed 'at;equested ThIS document when
srgned by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construction to commence Before occupancy, a Certiflcatl ~f Occupancy must be ISSued.
City Planner
Dale
, Special Conditions ~ any
24 hour notice lor all inspections 447.9850