HomeMy WebLinkAboutBuilding Permit 00-0166
DATE nilE
CITY OF PRIOR LAKE 1.-I'l-dJ
INSPECTION NOTICE SCHEDULED
ADDRESS I (,ty,{/ SOrd6Y\
OWNER CONlR.
PHONE NO. PERMIT NO. oO-O/he,
o FOOTING o PLUMBING RI o EXIGRADfFlLLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: roor
tTWORK 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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
------,------------------------------
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
rJ
,d 1-3
!
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
oo~ ( ~E:>
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN 3- 2.--"1-0 CJ
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom) BUILDING INFORMATION
2. SITE ADDRESS I ~o 111 -""'01" -" :5.c ~-2- 11. SIZE OF STRUCTURE
" .J (Height) (Width) (Oepth)
3. LEGAL DESCRIPTION 12. NO. OF STORIES l
LOT ?, BLOCK , PID 'Z~ -00 4-~"'...o
r: (") STvLl..-d<" Ai>D 13. TYPE OF ~~NSTRUCTION
ADDITION AnA.' .
4. OWNER (Name) (Address) (Tel. No.1 14. FLOOR AREA AI'lPORTIONMENT USE
Dr.' . :30 tvY\. Sa 1'\ Ilnr'l </1 ::ro.c.Lo." ()"W.s'b 440 - 7J:'j 7
5. ARCHITECT (Name) (Address) (Tel. No.1
6. BUILDER (Name) (Address) 5<;4./'1 (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
'fI<- ~ .J HI"(.5 OCCUPANTS
(;.o. t/ 1;r;-lhl<luJ/JI ~ ~ E f;/2 '}31-155'5
7. TYPE OF WORK Fireplace L] SepticL] DeckL] Re-roofing L] PorchL] SEATS
New Construction L] Alterations L] Addition LI Finish Attic L] Re-siding r Finish Basement L] 16. PROJECT COSTNALUE
Chimney 0 Misc. 'i I 70 0 - 0 ()
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No /..{- 10 - () 0
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 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 Off~ re~~ ceuse. Furthermore, I hereby egree thet the C;?;ffiCiel or a designae may enter upon the property to pertonn needed inspections.
X :.r;, rt>l7"3 - 2-., -d 0
Signatur License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
Actual SOIL TESTS 0 ENERGY DATA 0
Front "0' Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
~ 1+-/(2- SPACES REO. PLANS & SPECS 1':1 SETS
USE OF BUILDING SURVEY 0 COPIES
r SPACES ON PLAN
PERMIT VALUATION '2-SQO,- PLOT PLAN 0
TYPE OF CONSTRUCTtoN: I II III IV V Amount Brought Forward .................. $
Occupancy Group A B E F H I M R S U City:
Division 1 2 3 . Park Support Fee ........................... $
Permit Fee ................................... $ [.1\ .1') SAC u.......u.........u..u..u..u....... $
,
Plan Check Fee ............. ................ $ Collective Street Fee ....................... $
\. "2--":) Sewer Tap ................................... $
State Surcharge ............................. $ $
Penalty ....................................... $ Pressure Reducer .......................... $
Plumbing Permit Fee ....................... $ Meter Horn ................................... $
Mechanical Permit Fee ................~... $ Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & w/)ter P 'Jfu...... . $ WaterTowerFee ........................... $
Gas Fire t;.......u........~ Water Tap ................................... $
This Api Tl Builder's Deposit ............................ $
~ r-P'\lrt\ Building Permit Whe rove .
By Date Other ......................................... $
Certificate of Occupancy ~ Total Due .............................. $ 7C:>.-
Paid 'l'-. ~. Receipt No. 31111
Issued ~ 7>f. ("'0
Date By (U)kl-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as 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.
Cijy Planner Dale Special Conditions n any
24 hour notice for all inspections 447.9850