HomeMy WebLinkAboutBuilding Permit 00-0099
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUll!:D
ADDRESS \1..\1'..4 ~"All.dt).... Aw-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
,SYINSULATION A-
'" FINAL '"
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~
~~
\CJ~ ~\~)
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Inspector:
Owner/Contr:
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTl
_ f...ATj _. TIME
~ A--T
0-"1"'1
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
DATF RFCFI'lfQ
3/&/OD
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
6 0 - Of) r9
I
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 ADDRESS /0/ b Lf E(/e:jA/fbAlI1v-e-
1':fTc -0 \)
P-Z--
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES /
'A TYPE OF.7'Ns'rRUC"t;IO~
I(h ~ - g t!?':"t/.#1/c-
/14. FLOOR-AREA APPORTIONMEN-rDSE
LOT BLOCK PID 25-902--- nDS-Q
ADDITION /'1v'Ft"":~ hNO SaUNOS
4, OWNER .:RName) ~ s; (Add~eS~ (S'~.e) Z,~~/D
,<",VI . ,-j,a. e ~
5. ARCHITECT (Name) (Address) --' (Tel. No.)
6. BUILDER t1E:lJ!NGlQPI"'II~O '" Ml:MOUl:4KlA1i,s!Nl,.;.
4100 EXCELSIOR BLVD.
st LOUIS PARK, MINNESOTA 55416
Fire~ti~b ~:s~a.s~ePtic 0 Deck LJ Re-roofinQ'ljr' Porch 0 SEATS
Alterations 0 Addition ('] Finish Attic 0 As-siding 0 Finish Basement 9-, (16. PROJECT COSTNALUE
~LJR,()t,P ft-VI/__ '7./'/;I,"'1.7/'- /d'0I), ~ ? 0 ()
18. PROPERTY AREA OR ACRES 19. ~OPERTY DIMENSIONS 110. CULVERT SIZE '.h" <.../ .. 17. COMPLETION DATE
Sq. Ft Width Depth Ves No (r... r7.e1 s. hiM cA () d
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 prop 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
:Uilding official ok ~is pe~fo"~rthermore, I hereby agree that the city official or a deSi/Dyropon the property to ~Z~ections.
~9lb~at~.IW"",,-- License1:ro: Dale
U 1)- ~';~ fo~L
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/Z&
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEV 0
SETS
COPIES
21:::>u u.6V
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
,4 -1S--
City:
Amount Brought Forward .................. It
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .... ...... )t,
Sewer Tap ................................... ~
.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
I.t...~
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... <t
Sewer & Water Permit ...................... $
~:: F:r1r{:I#..........~;,~i~~.~.e~n w~j~4~d
By ,~"../, Date 1'fN
,~
Certificate of Occupalcy
Water Tap ................................... It
Builder's Deposit ............................ ct
Other ......................................... ct
Total Due .............................. $___::1/--. (j U
Paid 7 h. Q 0 Receip(H>. ~ (~ q!;;7
Issued
Date Jlb/O () By
This is to certify that the request in the above application and a......v., 't'.., 'fing documents is in accordance with the City Zonin6 ~ance and may pr 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 Certifica e of Occupancy must be issued.
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850