HomeMy WebLinkAboutBuilding Permit 00-0032
.
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED s,/l/O() /tJ/,y()
~S'tf f'attJ r flJ.,
ADDRESS
/63()t)
OWNER
CONTR.
{)O - 60.3 2-
PHONE NO.
PERMIT NO.
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: t2e. - Rcoi ~ ~ - ";3~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION If"\\
.l(FINAL ~
o SITE INSPECTION
(1fl;.., v~:)
~ WORK SATISFACTORY. PROCEED
(0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~, OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
Permit No. DD - 0 D3J..
1. DATE
1-1 Pc /.J r iZ<J A..D -5 '-=
/- fa.. oD
l'</sO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT .20 . L. \
ADDITION _)-1\ l\ Ii If S
BLOCK
FqZS+ i\J~P'+I'i)1J
PID.~<O:75'() 22-C;-O
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
,€S l\. L \\J I
5. ARCHITECT (Name)
(Address) J):lT'1. ~
:)" CO F ncl-
(Address)
(Tel. No.)
c) 0
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES
Sq. Ft. ff
SepticCl
Addition 0
Deck 0
Finish Attic 0
Re-roofing
Re-siding ~
Porch 0
Finish Basement 0
SEATS
16. PROJECT COSTNAI.UE
9. PROPERTY DIMENSIONS
00 Depth 2-O<J
10. CULVERT SIZE
Yes No
17. COMPI.ETION DATE
I hereby certify that I have fumished 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 . ruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
build~ can revoke this pe it for ju "fuse. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm be~ections.
X \..../( ~. '\ L. \... , oS ~ t)
~Iura License No. te
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
c:J ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
Let; ;:r/.e.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS c:J PERCOLATION TESTS LJ
USE OF BUILDING
PLANS & SPECS LJ
SURVEY LJ
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
7~~
Plan Check Fee ............................. $
I.'Z.-~
State Surcharge ............................. $
Penalty ...................... ......... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid
Sewer & Water Permit ...................... $
Issued
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni g Ordi ance and may procee requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifi e of Occupancy must be issued.
City Planner
Date
Special Conditions if any
24 hour notice for aU inspections 447.9850