HomeMy WebLinkAboutBuilding Permit 00-0131
DATE TIME
ADDRESS
CITY OF PRIOR LAKE
INSPECTION NOTICE
16602
CREEKSIDE
00-0131
- Re-Side
SCHEDULED
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
'leSE F!LE
Ndke F\:.. I 1::.1 ,:)vn, Buildih~ Ii I.:>>pt:;,-I vr"
DEe 2 ZUUJ
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
'NSNOTI
3i~;7~DO
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 ADDRESS
~ ~()~
3. LEGAL DESCRIPTION
10
J {)I#JNI1/~ off! qtll/f E2V ~_-=? ~
4. OWNER (Name)
J -,,/.s' iJ -.dlA~Jc..!iual
5. ARCHITECT (Name)
1. DATE
_s-/7-G>oo
~/'~f'3i,h,;~ r;/-C! ~ ..5 E',
K:-/
LOT
PID 25 -{ 04-- ()IL - 0
BLOCK
ADDITION
~.
1. White
2. Pink
3. Yellow
,._~,.,
r
Permit No. (J() -0 /3 /
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
~tJ;Z (/l"~~;oIo~:_"" 9S',2-YY?-23;;. ~
(Address) (Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
'1/t
~tPiLiiJ' t "?/- 9'3'CJ()
Re-roofin~ Porch 0
Re-siding V Finish Basement 0
J d~ ~ i 4...J1d <.
7. TYPE OF WORK f Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
IL~4:>1 S~JU :<,
Septic 0 Deck 0
Addition 0 Finish Attic 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION 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 me tioned property 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
buildin icia an rev~ ~ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neejed in,ections.
X ... _ ~ f_A-~ ~toF<; ~117/<UfA
Signatur~ ~ License No. Dale
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
'-J
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
8ack
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ---Z <:;;;?5V. ()V
USE OF BUILDING
12135 rt:/ Ii:-
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Permit Fee ................................... $
74-,1>
Plan Check Fee ............................. $
State Surcharge ............................. $
/.2\
Penalty ....................................... $
Plumbing Permit Fee ....................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Pressure Reducer .......................... $
Meter Horn ................................... $
WaterMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ _
Total Due .............................. $ "/ C:? . QO
Paid 7 ~ . ([l/ Receipt No.3tP 919
Issued .
Date~!t7/AI) By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zonin6= and may proceed &;~~uested. This document when
signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gai~ire~, per' ~... . ................ $ .
Thi . n B m Building Permit When
By.l Date
Certificate of Occ pane
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850