HomeMy WebLinkAboutDemo Permit 02-0550
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
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1. White . File
2. Blue . Cily
3. Yellow - Ap~icent
Permtt No.
oz~ 0650
DIRECTIONS
1. DATE
BUILDING INFORMATION
7. SIZE OF STRUCTURE
SPACES NUMBERED 1 THRU 10 MUST BE FILLED IN
BEFORE PERMIT ISSUED
(Please print or type and sign at bottom).
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B. NO. OF STORIES J
9. TYPE O~ CO}'STRUCTION
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10. COMPLETION DATE
2. SITE ADDRESS[ JJ/'1" .A>'J I , I_
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3. LEGAL DESCRIPTION
LOT
BLOCK
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Q30-0$O-O
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ADDITION :s t.vf.3 0, -1';v f' ,I Ji /), ,V
4. OWNER (N~el
UltllfA
5. ARCHITECT (Name)
W flee/off'
(AddreSS)
II..fJ.S'7 S~~, L /3eocL, 7Ic;!
(Address) 7
0el. No.)
95';;-"/96 -9D33
(Tel. No.)
6. CONTRACTOR (Name)
(Address)
(Tel. No.)
I hereby certify I have furnished information 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 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 this permit for just cause.
Furtherm~herebY agr~e Jhat th? city official or a designE1e may enter upon the property to perform needed inspections.
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Signature Date
FOR ADMINISTRATIVE USE
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METRO SAC UNIT DETERMINATION
MATERIAL FILED WITH APPLICATION
o Site Restoration Plan
o Utility Abandonment Plan
o Sewer Abandonment
USE OF BUILDING
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SITE RESTORATION PLAN
LJ Water Abandonment
Accepted by
Rejected by
o Electrical Abandonment
o Other
TYPE OF CONSTRUCTION:
"
III
H
IV
R
3
V
M
CREDITS
Park Oed. Credtt ................................................ $
SAC Credit ......................................................... $
Sewer & Water Connec. Fee Credit .................. $
Water Tower Fee Credtt .....................................$
(
Occupancy Group A
B E
Division
2
4
Other .................................................................. $
dThiS~. lObe hom youred /,AI, ~~ -./$ TOTAL CREDITS ........................ $
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By" /~ Date S--Fj -07 Issued by Date
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
cBCE!NAL
o SITE INSPECTION
COMMENTS:
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DATE TIME
SCHEDULED g't-oi
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CONTR.
PERMIT NO.
f?2-Ss-o
~Y~ILLING
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o FIREPLACE RI
o FIREPLACE FINAL
o GAS liNE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector~/~""" - Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONA/. HEALTH & SAFETY!
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