HomeMy WebLinkAboutBuilding Permit 00-0536
CITY OF PRIOR LAKE
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
/5'IIZ
"PPIf LOOS'"
,1't2- NG
3. LEGAL DESCRIPTION
\ I
~
ADDITION
1. White
2. Pink
3. Yellow
File
City
AppliClllt
Permit No. --.00 . 0530
1. DATE
~/.SO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heiaht) (WIdIh) (Depth)
JI)"J 3J I I ~.l
12. NO. OF STORIES
BLOCK
2.. PID ZS-30IJ.- 005-0
I iJ teA5P.8e~Je.Y R...IDt!!I~
13. TYPE OF CONSJRUCTION P~/~
&AtafI u.t / (i/M
14. FLOOR ARE.( APPORTIONMENT USE
LOT
2ND ADD^'
~~. fl (Na~)
',,(~~, (:)MJf ~ 117"'rI..
5. ARCHITECT (Name)
(Address) (Tel. No.)
~rb~ lSJJ)...~. ""IL'I~'I(,
(Address) (Tel. No.)
~...........'... ...'.*..~. EfI....... ..' (Name) IL ,JAddres!l. A _ ~ ,)Tel. No.)
<0:' ":' ""Jr ?ML. hI.".1(I' "1:.# FU1ut~ ~ ~s-)) qS'1, -'(11 (,.
~~.4J ,~~J;;;vr ...",.
7. TYPE OF WORK Fireplace a Septic a Deck)(. Re-roofing a Porch a
New Construction a Alterations a Addition a Finish Attic a Re-siding a Finish Basement a 16. PROJECT COSTNALUE
Chimney a Misc. S"" 11f1t'6~_.
8. PROPERTY AREA OR ACRES 9. PROPERTY-DIMENSIONS 10. CULVERT SIZE 17. COMPLE~ION OAT
Sq. Ft. _ Width Depth Yes No / lJ"~............... ~ 2.
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 ~ th 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
building .. I can revoke thi rmit f just cause. Furthermore, I hereby agree that the ci~ official or a designee may enter upon the property to perform needed inspections.
X MJI+- .1 O:H..c!!lN~ t.~~....-'O..,..:O'if'
i~;~",~
FOR ADMINISTRATIVE USE
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $JZ.4-. S!!I-
Paid /z- 4.'tro Receip 3112A...1
Issued . ~ _
Date 71e;: () 0 By
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoni~iance 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 Certificate of Occupancy must be issued.
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
.:3000.
USE OF BUILDING
~es A/R-
,.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Permit Fee................................... $
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
~4. 75
48.59
/.5D
Plumbing Permit Fee .. ... .. .. .. .. .. ... . .... $
Mechanical Permit Fee ..................... $
~
Sewer & Water Permit ...................... $
This
By
..... .... ...or.... $ / /
g Permit W~ L-v-ta..
Date re!J 70v
I I
Certificate of Occupancy
City Planner
Date
24 hour notice for all inspections (952) 447-9850
Special Conditions if any
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
. PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS a
SURVEY a
SETS
COPIES
PLOT PLAN
a
Amount Brought Forward .. .. . ... . ... .. .... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. . .. . .. .. .. . .. .... $
Sewer Tap ..................... ..... ......... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
- ....
P~IOR LAKE
INSPECTION
RECORD
SITE ADDRESS \ 5 \ \ 1- Af'PA'- 00:,1-\ ~ \ (L
TYPE OF WORK D r=:c-~ .
USE OF BUILDING . . ~ AI P I J
PERMIT NO. (JO - 053 0 ~DATE ISSUED (p /2t> /00 '
\ ~ ( . (
BUILDER '--to'1~ CDt-)~ ~ aN'€: ,....1~-1Y"-~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
..
FOOTING YJ;y 7/f4 ( /71)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~
FINAL
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECnON NOTICE
~=I~
\ \ ;to
TIME
SCHEDULED
ADDRESS 15112.. 4 rr~ 1h.-
OWNER CONTR.
PHONE NO.
b- 53G:,
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~=LATIO~
. L
o SITE INSPEC ON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.::CT e;;LL FOR REINS:::::::FORE COVEmNG
/
CALL 447-9850 FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
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