HomeMy WebLinkAboutBuilding Permit 00-0151
CITY OF PIlIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS y~e0 ~~ -<if-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
.qlINSULATION "-
'l't-FINAL r>-
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
If-,Y\r.L 0
nl,,<
DATE TIME
~ Ai
6-1 ~J
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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/
/(.J~
,
o CORREC
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Elf. )
/-
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ALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL ..47-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~QUlREfENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
V INSNO"
~._.~.._'----
~~
pATF RFr.~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
.2..
Permit No.JJ/J -OL!i.L
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADOPIESS 4380 /'? /lPL-GN ODD
~T
37# loa
.el
BUILflNG INFORMATION
11. SIZE O''STRUCTURE
(Height) ~ (Width) (Depth)
5E
3. LEGAL DESCRIPTION
J
12. NO. OF STORIES
LOT
BLOCK
PID Z5-/()S -()o/-()_
13. TYPE OF CONSTRUCTION
ADDITION
I.. OWNER
~t'l
15. ARCHITECT
.8.IlUl1.DER
em . riAl /II' /l.S
47lf
(Name)
RA-~-rL.1 {L
(Name)
(Address)
4sflL., fYlf+fLl weOO
(Address)
(Tel. No.)
~'T 5'E. W7-MTj
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~ ht.1;;ObL<:""
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
I\..,Wfl_ Sn-1='~t}',,~ ,."
Septic 0 Deck 0
Addition 0 Finish Attic 0
L..J
4LfI-1B12
OCCUPANTS
Re-roofin~ Porch 0
Re~siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. 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 all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding o~ia~e~~p.ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pe3r: i.ye~ODions.
. ~ Lio",,,, No. Do..
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS D PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
,et;SR/~
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
COPIES
SURVEY 0
2.5LJV .CIV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Division 1 2 3 4
Permit Fee ................................... $
7<1. 7 ~
Plan Check Fee ............................. $
State Surcharge ............................. $
/. 2. S-
$
Penalty ....................................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
Plumbing Permit Fee ....................... <t
Mechanical Permit Fee ..................... <t
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7 /c;. 0 0
Paid -7"c.. OV Rece~Pt No. '/() 4-
Issued
Date3h"'l" /m By
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 s requested. ThiS document when
signed by the City Planner constijutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertifICate of Occupancy must be issued.
Iding Penni! Whe1Ap~rI:J"
Da1e .3 ? !b(J
I .
This
By
Certificate of Occupancy
C~yPlanner
Dale
Special Conditions H any
24 hour notice lor all inspections 447~9B50