HomeMy WebLinkAboutBuilding Permit 00-0555
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DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
Qty
Applicant
~ /9t1!{fD
00 -0555
Permit No.
, 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
!G,.~
3. LEGAL DESCRIPTION
LOT \ BLOCK
~~ fOV\rbJ
<.OWNER B('3)s~'r'~ ,,<;'q? I.v<~~~
5. ARCHITECT (Name) (Address)
1. DATE
, -l~--OO
Pflb~(fik~ (ril
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
W.~5+~
V
~
~v
12. NO. OF STORIES
8.0 - ~ ctS"- t1:f1-0
PID
13. TYPE OF CONSTRUCTION
ADDITION
(Tel. No.)
VI(], I ,qy
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER
(Name)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7.TY~:!f '1to7:'!.~ f81P.s!:!791~~!~rVJrJ8.7p~!,!7
New Construction CJ Alterations CJ Addition CJ Finish Attic CJ Re-siding CJ Finish Basement CJ
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
. 9. PROPERTY DIMENSIONS
Width Depth
17. COMPLETION DATE
1 O. CULVERT SIZE
Yes No
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 that I am the owner or authorized agent for
the above mentioned pro rty 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 r e this permit f ust cause. Furthermore, I hereby agree that the city official or a desJs,.nee mal enter upon the property to perform needed inspections.
..-- 2.003.5 00, ~-7A,-OO
J ure License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: ReqUired
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS CJ
SURVEY 0
PLOT PLAN 0
SETS
COPIES
USE OFBUILDIN~ ~ ~
., z... t) (:)0, {J lJ
.
TYPE OF CONSTRUCTION: I II III IV W
Occupancy Group A B E F HIM (fV S U
Permtt Fee ..........~~~~~...1...~:?~... $ 1.a2. ZS
41J&'f'
UD
Amount Brought Forward ... ... .. ... . ... ... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. .. . .. .. .. .. ... ... $
Sewer Tap ................................... $
$
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee .. .. .. .. .. . .. .. .. .. .. . ..... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $ /O.3A 7 I
Paid ~3 -, I ReceiPt~O. '} VLf t
Issued . - 0
Date By (
This is to certify that the req . the above application and accompanying documents is in accordance with the City Zoning rdina and may proceed as uested. This document when
signed by the City Planner ~ a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of pancy must be issued.
City Plan~" Date Special Conditions if any
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Plumbing Permit Fee . .. .. .. .... .. .. .. .. .... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Pennit ....................... $
This "=00 Qeco~ Y$ding Permit w,en ~P~'
By r<<. L Date &. q ~O
Certificate of Occupancy
24 hour notice for all inspections (952) 447-9850
... ....
...
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS "ld3's wesr15L1/!..Y' Alt;I
TYPE OF WORK N 6U Dee!<
USE OF BUILDING teES A / ~
PERMIT NO. 00" 0 55~ -bATE ISSUED (o/3()/~t)
BUILDER Tt\-t)~~~ TttOM.f'~N ~SfI * &7':' ~79 7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DQCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
FOOTING t (j;r(/ 11;>-~/tn
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL
f .
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Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
()
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS t.~g9S"
.~
J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING ~
o INSULA TIO
'lTFINAL
/0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: '..J ~Z
(1Ji~ ~;h
DATE T1MIi
~~/Otl 3:~
IJ 0 - =::i--::: 5
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
}/J WORK SATISFACTORY, PROCEED
(;; CORRECT ACTION AND PROCEED
o CORRECT WOR~ALL FOR REINSPECTION BEFORE COVERING
Inspector: ( Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/NSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
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