HomeMy WebLinkAboutBuilding Permit 00-1003
190 PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
plication which is to the besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
t all nstruction will conform to all existing state and locallaw$ and will proceed in accordance with submitted plans. I am aware that the
r' sl use. Fu rmore, I hereby agree that the Ci~i~~nee may enter upon the property to ;1~ ~~d:S8e:os'
S....ature LICense No. Dale
6~~
QAIEBI=r.I=I"Fn
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
11'2.}00
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
I \- ~ry -f)O
fRw~ ~
2 SITYlTt1t: 1~E 11"< 0 \M' L )
3, LEGAL DESCRIPVON
LOT \ . tlLOCK ~ PID -.25-31.;2..- 0 I (" ~O
ADDITION v..1\.11'I fl. H ILL 4 Y\ ADD 11'"10 ,J
4. OWNER {Name)...... ..... (Addre~ (Tel. No.)
Oh'riE L~~I :I..tLo'l'1#'..A...... Lt),J S 7Y2M. C /" J,J, :r IV G
5, ARCHITECT (Name) 0. , (Address) (Tel. No,)
~')') E...
6;~L:~ '1&;e~~T ~~~H
D~
Finish Anic [j
(Tel. No.)
".CS )-~2 - 1'7'1 )
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic [j
Addition 0
Re.roofing 0 Porch [j
Ae-siding 0 Finish Basement 0
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
1.
2,
3,
File
City
Applicant
oo~
~~..: ~~
BUILDI FORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATJ
16, ~~ECTCOSTN"\PC'!
Lf ~O.--
17, C24'F>tETION DATE
\ L-I~-&o
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
<
Pressure Reducer .......................... $
MeIer Horn ................ .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ..... ................. ................... $
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~o. 0
USE OF~L~ING Jt \\- L
TYPE OF CONSTRUCTION: [ II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
R S U
City:
87. ?.e:;-
~(".71
?CO
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
.................... $
............ $
uilding Permit '/'Iren APl2!.oved.
Date II--L~I-~
SOIL TESTS
LJ ENERGY DATA
"
PIUNG LOGS ~ PERCOLATION TESTS ~
PLANS & SPECS ~
SURVEY ~
PLOT PLAN ~
SETS
COPIES
Total Dua .............................. $ , '15. '71,
Paid /45.Q(, Rece~p .3"B(..e~
Issued
. Date/(.z.7.{flJ By.
ThiS IS to certify that the request In the above apphcation and accompanYing documents IS In accordance With the City ZOning Ordlrfance and may 1-" ~~~~1.:..3 requested This document when
signed by the City Planner constitutes a temporary Certificate of ZOning compliance and allows construction to commence Before occupancy, a Certificale of Occupancy must be ISSUed
C~yPlanner
Dale
Special Condrtions if any
24 hour notice for all inspections (952) 447.9850
..
PRIOR LAKE
INSPECTION
RE,CORD
SITE ADDRESS ~~\ ?t,~ b~N<O C}'t--
TYPE OF WORK . '--
USE OF BUILDING
PERMIT NO. ()Q -)(')() ~ _ DATE ISSUED If - 2- /_ ?"""Q::::I
BUILDER .M.1i-e.D_ "l/Q..,., J.~ ~,,~ - .~S/ - ')2.;':'1'), /
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I
/
I FOOTING ~NSPECTOR L II/';;~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I r
I FINAL
I f0, I /Z//$/oa
Call between 8:00 and 9:00 A.M: for all inspections /
FOR ALL INSPECTIONS 447-9850
I
I
I
"
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1'2.-1<;',00 4\U7l
ADDRESS
/4453
6c--UG81 I2D
OWNER
CONTR.
PHONE NO.
PERMIT NO.
O~/003
~.._-,.-..._-
F' (OO~
"--- ,
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FI,flEPLACE FINAL
GAS LINE AIR TST
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING J@ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~FINAL DE.C '0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
""''''''-'-"''-
~
,~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~LL FOR REINSPECTION BEFORE COVERING
Inspector: q- , Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl