HomeMy WebLinkAboutBuilding Permit 00-0123
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS \\01 So Avu:-.J i?;
OWNER
CONTR,
PHONE NO,
PERMIT NO,
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING (8 0 WATER HOOKUP
gANSULATION 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
o SITE INSPEC 0 MECH FINAL
COMMENTS: ~s:de
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DA"f
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TIME
q:Jo
0- /26
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~
V
&0
V WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WOR'2t~LL FOR REINSPECTION BEFORE COVERING
Inspector: W~ I Owner/Contr:
I
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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3/5lao
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
ApplicaDt
Permit No, 06 -()/23
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
3/15:/ro
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
2, SITE ADDRESS
1&/ftJ ~ ~ ),E,
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID 7,t::) -QQj- /f/U- - ()
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
5. ARCHITEtT
,J /~I {O a;,;;Jk
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
L/ I./J.::. '=.q1tJ
6, BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~('J
7. TYPE OF WORK Fireplace LI
New Construction 0 Alterations LJ
(,9f( ~ (+ lJ.~, 'l.:1./1-m I
Septic 0 Deck 0 Re-roofing 0 Porch 0
Addition CI Finish Anic 0 Re-siding \( Finish Basement 0
OCCUPANT~
SEATS
16, PROJECT COSTNALUE
Chimney LJ Misc.
B. 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 m ioned p perty an~:l~ft(lstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding 0 rev thif':1~~use. Furthermore, I hereby agree that the nr.r~or a designee may enter upon the property to pertorm,'lilerr;:;;ionS.
Signature License No. I ~e
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
CJ
/l//Z
,
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
It!-
PLANS & SPECS 0
SURVEY CJ
SETS
COPIES
PLOT PLAN
CJ
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ........,................................ $
Collective Street Fee ............. .......... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Hom .................... ........ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Permit Fee ................................... $
747)
Plan Check Fee ............................. $
State Surcharge ............................. It
Penalty....................................... It
Plumbing Permit Fee ....................... It
/. 7_ S-
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace ermlt ....................... ,It
ThiS' nB m..jJ,d'i1dingp.rmit~~f)l."
By '7..J,'Q(, Date I ~I (J U
Certificate of olpanl
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7 ~ . cJ2".- Receipt 0
Issued -
Oat. :~/I)/OO By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning' Ordinatce and may proce 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.
v/t.. (/ J
'(~9/0
City Planner
Date
SpecialCondrtions ~any
24 hour notice lor aU inspections 447-9850