HomeMy WebLinkAboutBuilding Permit 04-0620
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OATF .OCFIVFO CITY OF PRIOR LAKE
BUILDING PERMIT. .
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I 'O,,~
DIRECTIONS
SPACES NUM8ERED 1 ntRU 17 MUST B~ f-lllED IN
BEFORE F"ERMIT 1$ ISSUED (~I..se PflnI Of T~ and .10:;9" al Milam)
.. sITe AOO~ESS ~
557::1 r.~CJJ
3. lEGAL DESCRIPTION
.,
LOT
ADDITION
I I'tei I
?-
1
z...i ZI"f. 06'l.u 0
PIO
BLOCK
Jrt/'/('/ Flt/eA/",/,-
(AlJdre!ils) ~_ ,~"..._. I'"
~C~'Tr
(Addren)
(Tel. No.)
~..J..()3-114aq
(Tel. NO.)
4. OWNER
\N~e)
R'r-~ 0Pr\C,p(\
S. ARCHITEC'f (Name)
.6;1=~[qIl~(NlJam.~ ('",,,-I,., -I- tJ~1'~Ii:oI~tAIle5. ;;~""07-
, ~ ~~DfS 8utn~1/11 Ie ( (1IN...!::b~' (.p,c;q .
Re-roonng (1 Por;n ::1
fltc-$dl.,)( A"'&I' 8..."tSerTllilnt C
Fireplace n
Al1erallons 0
Deck'"
FinlSflAUIcO
I. While
2. Pink
3 Yellnw
Fik
City
^pr1ica.n1
SeptiC (1
AOOirtonO
Permit No.
04 _ 0 &ZO
I
BUILDING INFORMA nON
I ,. size OF STAUCTV~e
t~\ tWld\tlj
(Ooplhl
12. NO. OF i~e,
13. TYPE?{ CO~S~CT10N
. !<,e. $,I,1.\.!l'{l
1.... FLOOR AREA APPOR-m3NMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
Ot
OCCU~ ANT~
SEATS
7. TYPE OF WORK
New CoNlruCllon 0
CnltMey 0 Mlsc.
8. pf:\OPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS 10. CULVERT SI2E
Sa. Ft. W,~ Oeptl'\ Yes No
I hereby urtlfy 1hal: I have lvmhlhecl lnlormaoon on 1his applleatk>n wl'llch as 10 the t>eSt of my knOWledge fnJe iJl'\d correct I also c:ettlfy INlI I iIIm rhe owner Of IIUlhoriz.ed aQenllor
tt'1t ,,!:love menUoned property and ht $ C()I'\S\rue1lon will conlorm lO 811 e:r:lstlng slate and Ioe&I \aws and will P"Xeoo: In 8CCOrOance with 5ubmined ClflnS. I am awe'" \hallhe
buJkf~"1c:WtI can ~IS .m'IIt or ju~t ~V$.. Furthen'Tlore. I hercO)' agree th&1 the city olliC\,,1 or a des nee may enler UDOf\ the property to pef10nn needed In3pection.$;
X ~UiIr... .. .~ In-IS 1;J-
UP1I l~S41 No. 03\e '
. SETBACKS: .oqul'" _
Ac\ual
FOR ADMiNisTRAT'f,jEUSE
.-
BUn..OING OEP-",TMENT VALVATION
D.",
....
Side
US! o. SUllOlNG _
OFF STAee:T PARKING
SPACES JlIEO.
SPACeS ON PLAN
PERMIT VAlUATION
1~ P~O~~CT COSTNALUE
it> iALW.~
17. COMPL.TION OAT.
MATEAIAL FILED WITH A""UCATIOH
SOIL TESTS 0 ENERGY OATA 0
PIUNG lOGS 0 pERCOLATION TESTS "
PLAN..';" $PECS 0
SURVEY 0
SETS
COPIES
'LOT PlA.N
n
TYPEOFCOfIIS1"RUCTlOff: I n III IV V
OcoupAncyC...." A S e F HI" A S U
~12!'
P,rtI'lIl Fee ..........h....................... S
P&en Chd Fee ............_................ S
Slats SUrd1l1rge .........._.................. S
Penlllly ....................................... S
~Perm1lFee _...................... $
Mechlnlcal Permit Foe ..................... S
SlMr&WllerPennIl; .................._... S
Amount Brought Fo1'W;lro m............-.. S
Pen Su~O" Fee .........______......~...h $
SAC ..........................................
Collective G\roet Fe. .........-..-.........- $_
Se'oVel'Tap ........................-.......... $
S
Pres&ur. Reducer .......................... ..
Metertiom................................... S
W.t.rUeler .........................._......"
Sewer & Wa\er CO,",neclion Fee ........... S
Wa\erTOW'tf Fee h......................... $
Wa\orTap ...".............................. If.
&\.I1Id.... Deposit ............................ S_
Oth., .................................-....... '-
Tolll OUe ............._................ S
PoId 7(, _rlV -"9
0... G.'Z.-z.-..1- By ..(....
ThlctstaOllRtfyV16l...~lnlheabO\ltl.ppllcallOnand ~~. _,., . .dQeumenISIsIn~.ncewlthIheCUyZonngonfW'llJnceandI'MY~;&requeS(ed. Thlldoc:uf'nenf~
,igntO\Yy~CftyP\ennef~.~c.rtir(:a~afzonil'lg.. ~'.. ._.nd.brt$.... ,~.:. 1OCCll'TUn8f"C18 BelcnOCC\Ofnc:y.a [701CXOJpr1rqtl'lUSlbllRlKJd.
e..,~ 01_ $oKlaICOrdlllcNif...., J
Cllyo
...._.....P_ ....................... S
Thia Aof;lIeaIIon leocom_ Yovr 8uIIctlng Peomtl When ,e.,oprO'll<<i.
By Dele
Certlflc:8l0 or 0ceup.\r'C)'
Issued
i
I
r.
~i~
'). _,p..,.t;..., I"r 1Il11ncnfo:dr.ons 447-98)0
/(;.vu
c:t -z;./ ?
DATE TIME
SCHEDULED ;;/f6/
Cectr~O$d 1)/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
sS?;2
OWNER
CONTR.
PHONE NO.
PERMIT NO.
y'- 6.2.0
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~AL 0 PLUMB~NG F AL
o SITE INSPECTION ,.J.1MECH FINA
COMMENTS: ~6' 0 _ ~.
/ 2 // -
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v:yl S, '(/>'1-'- OA <Si'~c:.
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~;/cJse_r/~ -
~ORK SATISFACTORY, PROCEED b<-/ ~
CORRECT ACTION AND PROCEED '/ C
! 0 CORRECT W~~ '~R REINSPECTION BEFORE COVERING
Inspector: I" v~ Owner/Contr:
CALL ~7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
msNO"
CODE REQUIREMEN7S ARE FOR YOUR PERSONAL HEALTH & SAFETYI