HomeMy WebLinkAboutBuilding Permit 00-0079
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/L/59Z-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
-BJ_NSULATION A
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o SITE INSPECTION 7
DATE TIME
SCHEBULED y'l"o/OV A.T.
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
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RY, PROCEED
D PROCEED
L FOR ::?PECTION BEFORE COVERING
Owner/Contr:
CODE
HE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
FEB 2 5 2000
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. OO-Q:L'i
6. BUILDER (Name) (Address) (Tel. No.)
~~_. (PU{~Sf,~, 'fC(?~Xftl
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction 0 D Altaratio (J Ad if 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc. _ ~... 0--
18. PROPERTY AREA OR ACRES 19. F'ROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished infonnation 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. f am aware that the
:uilding Offici~,;;;J;"P.S 7't'1f!1;;e. Furthermore, I hereby agree that the cily official or a ~s"f-e5r enter upon the property to perto"f.{:; ~S.
t Signature license No. Date
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2 SITE ADDRESS/ L/ )91- 44 Ii: 0:
3. LEGAL DESCRIPTION
..3
CE.
'r;;r/J-o
I
R/St)
LOT
2-
13~,qe.-f/
(Address
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PID 25-/3'f1>-oq-O
4m
BLOCK
ADDITION
140WNf
/5, ARCHITECT
()AJ::/AND
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
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC .,.,,.,.,.,.,.,..,.,..,.,..,.,,.,..,.,.,. $
Collective Street Fee .... ................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ,....,..,.,....,..,..,.,..,.,. $ 70,00
Paid '7 (p . 00 Receipt No. ~ <..
Oate 2.~4S,,"OO 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 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.
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
.e.GS 1I.e..
PERMIT VALUATION
2. !=)oC>
TYPE OF CONSTRUCTION: I II Iff IV V
Occupancy Group A B E F HIM R
Division 1 2 :3 4
PennitFee ................................... $
S U
City:
7 '1 . 7e...;'
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty...................... ................. $
t.7_<::
Plumbing Peffilit Fee ....................... <1:
Mechanical Permit Fee ..................... t.
Sewer & WaterPeffilit ...................... $
;:: :Z5~7~~~muu; ~~;I~i~~.~.e:it When Approved.
By UT/r::;::;:.. Date --2.;1.0:; -,~
Certificate of Occupa
Issued
C~yPlanner
Dale
Special Conditions ~ any
24 hour notice for all inspections 447-9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS LJ
SURVEY LJ
SETS
COPIES
PLOT PLAN
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