HomeMy WebLinkAboutBuilding Permit 00-0392
DATE
CITY OF PRIOR LAKE
INSPECTION NOTICE
4621
_ PLEASANT
00-0392
Re-Roof
SCHEDULED
ADDRESS
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
..... EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
("'-05~ F!b.~
,V,ike Peterson, Building It.~p\:.~ I VI
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 & SAFETY/
INSNOTI
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3, Yellow
File
City
Applicant
bJ~~/CfO
Permit No. rlO - (j.3q d.
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.J b d) P (0 11 ~n n:\- S. t- s e
3. LEGAL DESCRIPTION
1, DATE
s18-yJ(J()
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT 1(")
ADDITION ~ V '? r~
4. OWNER (Name)
f11;ld iEl
(Name)
BLOCK ~
L~i q
If., a.U~
PID d..S~OO d-OdX'-Q
~ AOON -
13, TYPE OF CONSTRUCTION
5. ARCHITECT
I{ l (' (Address)
~I/.('V ~
V (Adtfress)
(Tel. No,)
14, FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER (Name) (Address)
7TYP€2 !!f::.,~~s,,,,o
(Tel. No.)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction a
Alterations a
Addition a
Deck a
Finish Attic a
b{
Re-rooli Porch a
Re-siding a ish Basement a
SEATS
16. PROJECT COSTNALUE
Chimney a Misc,
8, PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 0, CULVERT SIZE
Yes No
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 mentioned 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
:uilding OffiCi~. v:o~kee In th;'i~S t::t fo.r jU~ Furthermore, I hereby agree that the city official or a designee may enter upon the property to pe~JJqldlJections.
t~~~ '\ License No. DAte
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS a
SURVEY a
PLOT PLAN a
SETS
COPIES
USE OF BUILDING ~ ~j~
I
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 ................................... $
ry L/.' 'S"
Plan Check Fee ............................. $
State Surcharge ............................. $ I. rl ~
Penalty. ........ ............. ................. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ '7 b. ''0
Paid 7 l. ()1) Receipt NO.1, 747 b
Date ~ 1J-4 Juo By / k'A) .
. I ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proce as r uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifica of cupancy must be issued.
Gas Fireplace Permit ....................... $
1
ThiFi tio~ B{ ;)'1e;;l~ou':..Building Permit~ Apprp,vfl,d,
By U-, ~~ Date () Mit //'V
" . . ,
Certificate of Occupancy
Issued
City Planner
Date
Speciat Conditions ~ any
24 hour notice for all inspections (952) 447-9850
.--