HomeMy WebLinkAboutBuilding Permit 09. 0856 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 10/31
ADDRESS .. 5 (J d Lir 7 7.!/21,, , .I,mIJ S
II- 7 It - S'
OWNER CONTR. 1 { - tjt
PHONE NO. PERMIT NO. iii, �� [ v
(i) i
❑ FOOTING ❑ PLUMBING RI 0 EXIGRADIFILLING
❑ FOUNDATION ❑ MECH RI 0 COINPLAINT
O FRAMING ❑ WATER HOOKUP 0 FIREPLACE RI
O INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL,
NAL ❑ PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION ❑ MECN FINAL /f 0
COMMENTS: 0 .$ GiS t... li . - '
t,,./.t / ,00 . r '/� �a* , +,
d tJt . t
P 2f/i i cr-‘1 .----------
IN, _.._.. Ls / .r
.. ,
D WORK '$ i.` - K s u • :.. •
ORRECT ACTION AND PROCEED
0 Cs - • " • - 4 41 FOR REINSPECTION BEFORE COVERING
Inspector•. Owner/Contr.
CA ( . 7 8 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE
CODE REQ111.1tFMENTSARE FOR YOUR PERSONAL HFrLLTH &' Sr4FETYt
NSNO ,
a,la lxi-G(G (% 113
, F PRA ,9R DATE RECEIVED CITY OF PRIOR LAKE 1. white File
� �
`� D BUILDING PERMIT, 2. Y w Applicant
m
/� 7 .
`
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No. BP 0? 10,056
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN / 7/ 5 1 9
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) BUILDING INFORMATION
2. SITE AD,DRESS �� , / ) , yl a ZONING 11. SIZE OF STRUCTURE
5 D O ' / i ° J) i wood I �/( /t r (Height) (Width) (Depth)
3. LEGAL DESCRIPTION 12. NO. OF STORIES
LOT BLOCK PID
13. TYPE OF CONSTRUCTION
ADDITION i a Sre,(l do S►10A1/1
+,OWNER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
M►IIISIS tilt ifftr0 - T ci- U n wvcci LN �✓1urtam 10
5. ARCHITECT (Name) (Address) (Tel. No.)
6. 1 B / UIILDER (Name(' E)) k) (l (Address) _ gel. No.) 7 15. NUMBER OF OCCUPANTS OR SEATS
J1V+h ( V O U Jryln VI 1 i , M I6 el ✓"l � . UU OCCUPANTS
7. TYPE WORK • Fireplace O Septic O Deck O Re- roofing O Porch O SEATS
New Construction ■ Alteratio.s O A•dit'•n O Finish Attic O Re- si•ing O Finish Basement 0 16. PROJECT COSTNALUE
Chimney 0 Misc. . I l. .. / / /, i _All . . / 4 l ti
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No
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
_ urthermore, I hereby agree that the city official
buildi official can revoke this ertmit for just cause. Furthermore, o a designee may enter upon the property to perform ne ed i pec'ons.
L� 00 5 /0 �
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
Actual SOIL TESTS 0 ENERGY DATA O
Front Back Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REQ. PLANS & SPECS 0 SETS
USE OF BUILDING
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION
5C0 PLOT PLAN
TYPE OF CONSTRUCTION: 1 II III IV V City: Amount Brought Forward $
Occupancy Group A B E F H I M R S U Park Support Fee $
Division 1 2 3 4 SAC $
Permit Fee $ %$ ° Collector Street Fee $
Plan Checking Fee $ 16.2S-- Sewer Tap $
License Check Fee $
State Surcharge $ Pressure Reducer $
Penalty $ Meter Hom $
Septic System $ Water Meter $
Sewer & Water Connection Fee $
Other $
Water Tower Fee $
" = $ Water Tap $
This ppl' .
P : ,i. . : uilding Permit Wh Ap roved. Builder's Deposit $
By A Date /d Other $
f Total Due $
Certificate y c
Certificate of Occupy Paid 4t/ 7.,,5 Recei p . C/ 47
Issued <
Date /0. /9.6 ? 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 pr• •. a, s requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning complian and all s oust on to co nce. Be a •- ncy, a Certifi of Occupancy must be issued.
t,,Id er a ( f ttS r
City Planner Date Special Conditions if any
24 hour notice for all inspections 447 -4230
•
•