HomeMy WebLinkAboutBuilding Permit 00-0129
9/v/o /
/4-764- eU3JDAt-C" 41/6
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION~
FINAL
~ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(l2n-a.e -.;J("
DATE TIME
AT<
O() .fJ(~
/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~ FOR REINSPECTION BEFORE COVERING
Inspector: If(71 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
.-.----.-..-.. . ~""-_.,_._.._._._- -~-'----"--"------~----
~~
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QA TI= ~:lI::r.J:I\l~.Q.
3/17/06
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)
2. SITE AOOREj t17 t) t-/
1. DATE
56
3-/7-00
e/SD
3. LEGAL DESCRIPTION
~le L1dflJ e
/
lfFJ-JeH
7/:)-(~(" -005-()
2ALD
Ll4':) 6 Y r ;),
LOT
."')
BLOCK
(Jill::' /AIv'D
PID
ADDITION
4. OWNER
JIb';
5. ARCHITECT
(Name} I (Address)
T> 12 ~ I mmCr7 "-
(Name) (Address)
(Tel. No.)
6. BUIL~ (Name) (Address)
t/t~~'I i;t~:-~~6
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction [j Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Misc.
6. PROPER1Y AREA OR ACRES
Sq. Ft.
(Tel. No.)
'ILl7- 2.QYCl
Re-roofing ~ Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
1 O. CULVERT SIZE
Yes No
Width Depth
t. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. DO - O/2fl-
I
BUILDING INFORMATION
11. SIZE OF STRUCTURe
(Height) (Width) (Depth)
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
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for
the above mentioned .~~~nd t t all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
~Ullding o~n reT;;} "r' se. Furthermore, I hereby agree tha:;:;;; ojCI;r4s17.5 ~r upon the property.o pert~':i~e~ ~lonS.
I Signature License No. - Date
r
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Amount Brought Forward ..................~.
Park Support Fee ........................... $:
SAC ......................................... $
Collective Street Fee ......... .... .... ...... $
Sewer Tap ................................... q:
.
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
2':::>UU.61.)
USE OF BUILDING -1? F <: ~ I L
- - /
PERMIT VALUATION
1YPE OF CONSmUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
5 U
City:
14-1C;;-
Plan Check Fee ............. ................ $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
{. z...r
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
Cl
Pressure Reducer .......................... If.
Meter Horn ................................... $
Water Meter ................................. ot
Sewer & Water Connection Fee ........... ot
WaterTowerFee ........................... $
Water Tap ................................... $-
Builder's Deposit ............................ ot
Other ......................................... If,
Totel Due .............................. $~ .O{)
Peld 74-.0 ""7
Da'e -:>.,h ~O
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni~rdina and may proceed 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.
Sewer & Water Permit ...................... $
Gas Fireplac Permit ....................... $
Th~ ' ur Building Penni. 1t~7,.ie9'
By Date -5 !(jU
Certificate of OCcupancy
Issued
By
24 hour notice for all inspections 447-9850
Special Conditioos ~ any
Dale
City Planner