HomeMy WebLinkAboutBuilding Permit 00-0898
6~~
D.A~RF=r.F=I"F=o.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
1. White
2. Pink
3. Yellow
/0 . ~ .00
2. SITE ADDRESS \ L\ 4 ~ L\ '\Z.a. \J Qn 0.;\ ~(-\-
~.
'o-lo- Db
eI
(Depth)
3. LEGAL DESCRIPTION
LOT d- \ BLOCK
ADDITION \Lv\r\ h \-\-) \ \ '2l-\i\.
4. OWN~ (Name) . (Address) (Tel. No.)
C 10)-,1:Y) - 'S:,\^{l,vi. [he J VV\b 144dl.l. Qu.lU'Y1lW.\;: L\~:y.lltB
5. ARCHITECT (Name) (Address) (Tel. No.)
12. NO. OF STORIES
\
PID?~.
Adcl'1+1 ~
3&'fiJ. tJ2/. 0
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
\ \; ri,w
7. TYPE OF WORK
New Construction CJ
J ~d
Fireplace b
Alterations CJ
(Address) (Tel. No.)
~~,,\.:,,;~\Iz. "rd" ~~
C'\,t-;::.'l~O \'~'J.:-'.\ ?~"J I
Septic 0 Deck 0 Rs-roofing 0 Porch LI
Addition 0 Finish Attic 0 Re-siding 0 Finish Basementt}
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
6. BUILDER
(Name)
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth 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 property and thai 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 this permit for just cause. Furthermore. J hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
17. COMPLETION DATE
x
Signature
License No.
Dat.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
1CB5 #/ "'-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2.oo~
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: t II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
s U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Permit Fee ................................... $
(,Z.25'
Plan Check Fee ............................. $
State Surcharge ............................. $
1.00
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ............. ........ $
40,fJ 0
Pressure Reducer .......................... $
Meter Horn ....... .... ........................ ~
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
~ti~. P:~~;,~i~.~..:itWhen App~ved.
B Dat. (O..(".~..
Certificate 0 ancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /0.3. 2 I
Paid /tJ3. ~/ R.C.ipt!ll9..3e4Sb
Dat. //).(;,.0 () By fl--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordi~ance and may proceelas 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.
---
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections (952) 447.9850
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 144- 24- /GAJJ57V CA
NATURE OF WORK L. L. F/ tV ISH
USE OF BUILDING K:.f::-c<; RI/2--
PERMIT NO. ()O. OfYlf:J DATE ISSUED /0, (p. 00
CONTRACTOR ~IfFI /M 0
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
~
HEATING (if required)
m.
~.
11/3/61:>
// /3/(J1)
A
tJ7.
111t3/~
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
~ -
HEATING ~
DO NOT OCCUpy
Ik
3/b/t1&
-
IA 3/10/12/
UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00.A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
3ft. /,.z.". JO ~ "'lJ
, ,
ADDRESS
/ 7't.f 2- <-I
~ ('JI...
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
INSULATION 0 SEWER HOOKUP
FINAL " PLUMBING FINAL
! SITE INSPE TION fB 0 MECH FINAL
COMMENTS:
L.t.. .
(1 f/rrU
L.,.-"
~
..- ....)J ./ .
t!J~ - 9'9 ~
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W::fR CALL FOR REINSPECTION BEFORE COVERING
Inspector: I Owner/Conte
CALL 447.9850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!