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HomeMy WebLinkAboutBuilding Permit 00-0553 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT DATE RECEIVED tp/30/00 - 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" ~ '"5L.f 3. LEGAL DESCRIPTION '2 ~. ~ LOT ..) ADDITION tl\/l.Jt'~ _., (Name) I I .~."'~"." 1< ~ 'Vl roe- or \ } a.J4..fA-~c.. -c "" 5. ARCHITECT (Name) n~h f>o,n~ ~ BLOCK , Q1'A- At1)N ~E 1. White 2. Pink 3. Yellow File City Applicant Permit No. DO ~0553 1. DATE ~ / , /00 R/50 BUILDING INFqRIIA TION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) 12. NO. OF STORIES PID a~,.. (j 4 'if -00 4 ...() (Address) (Address) 13. TYPE OF CONSTRUCTION (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE c:..c ( <. (Tel. No.) ':sri5 -- S1:4 ~ (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS ~" f/lDHS ~i:t~OFWORK ." 1Wlteonstructlon [] (Name) (Address) 6FL-4Y7-LfO') dv; \ol~ Septic a Addition 0 Dec~ Finish Attic 0 Re-roofing a Porch a Re-siding 0 Finish Basement 0 SEATS 16. PROJECT COSTNAlUE Fireplace a Alterations 0 Chimney a Misc. 8. PROPERTY AREA OR ACRES Sq. Ft. . 1 O. CULVERT SIZE 9. PROPERTY DIMENSIONS Width Depth 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 pro~ 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 official can revoke e', for just ceus Furthermore, I hereby agree lhet the cily offIdal or a designee may enter upon the property to POrto? nei. I..ns....... p.~ .~ s. xl <..,JI'. ZeJO(PQ-5Q7 -,;;:-C(U V License No. ". . '.. / FOR ADMINISTRATIVE USE Pressure Reducer .......................... $ Meter Horn... .. .. .. .. . .. .. .. .. .. .. .. .. .. .. ... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ Pa~ ~e ...................~~~o:~ ~ Date '-S" ...~OO 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 proceed as requested. This document when si!JIed by the City Planner constitutes e temporaJy Cel1ifice1e of Zoning ~Iance and e110ws ~ _to """"D""~~~~ 01 ~ IOOSI be issued. City Planner Date ~ Special Conditions if any ~L 24 hour notice for all inspections (952) 447-9850 \J SETBACKS: Required Actual Front Back Side BUILDING DEPARTMENT VALUATION OFF STREET PARKING SPACES REO. SPACES ON PLAN USE OF BUILDING ~ A1 :r,~ -"\ '- PERMIT VALUATION TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R S U Division 1 2 3 4 Permit Fee ................................... $ City: Plan Check Fee ........ ............. ........ $ State Surcharge ............................. $ "'7c.t. -Z S- ~~ I.S:O Penalty..... .................................. $ Plumbing Permit Fee ....................... $ ~~ ~ Mechanical Permit Fee ..................... $ Sewer & Water Permit ...................... $ m - ~."~"."':i:.~':_WC:~~ ...-. ~ Date - 5l/-rOO~ Certificate of OccuZcy Issued Side MATERIAL FILED WITH APPLICATION SOIL TESTS a ENERGY DATA a PILING LOGS a PERCOLATION TESTS a PLANS & SPECS a SURVEY a PLOT PLAN 0 SETS COPIES Amount Brought Forward .. .. .. .. .. .. .. .... $ Park Support Fee ........................... $ SAC .................................. ....... $ Collective Street Fee .. .. . .. .. .. .. .. .. ... ... $ Sewer Tap ................................... $ $ - .... ..., .. : P RIO R LA K E ~~rtD~~:~r::D~:SPECTION INSPECTION RECORD SITE ADDRESS JSS5'1 ~ fll- R.{J, TYPE OF WORK i:kc~ ~ t:t "xs ~ ,. USE OF BUILDING S~ D PERMIT NO. 0.0 -()55~ DATE ISSUED (.- 30-~ BUILDER -11.a k,\ t$v"((r~ ~ NOTE: THIS '15 NOT A PERMIT FOR A~Y OF THE INSPEC"fIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS 1~.s3'-1 ,.',--.;.' ,~" SCHEDULED ~o, ~ P~f @~ A~ /', OWNER CONTR. PHONE NO, PERMIT NO. {)o - 553 o FOOTING o FOUNDATION o FRAMING o INSULATION ~ JJm FINAL {Y o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FI"-' COMMENTS:~ It .. '11/'>' ~,,:_~ o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o '.' "WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WO~L FOR REINSPECTION BEFORE COVERING Inspector: ~ . Owner/Contr: "J CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTl