HomeMy WebLinkAboutBuilding Permit 00-0694
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
IlId S'(l-J
3. LEGAL DESCRIPTION
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DATE RECEIVED
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ADDITION
4. OWNER (Name)
A,.'1VI.J ,) <::tJrU
5. ARCHITECT (Name)
6. BUILDER
(Name)
j'-1-r <
7. TYPE OF WORK
New Construction Cl
...--
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Fireplace 0
Alterations 0
Septic 0
Addition 0
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
jO _ILl
P;mit N~.-,iU - (')?.4 4
1. DATE
~ Iflq J/ril
PLJ~I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID d5'- Ci IS - 04'-1-0
L/+" AOO:tl.J
13. TYPE OF CONSTRUCTION
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
Deck 0
Finish Attic 0
SEATS
16. PROJECT COSTNALUE
Re::e90 Porch 0
Re-Sidi", Finish Basement 0
Chimney D Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yas No
I hereby certify that I have furnished information on this application which is to the besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above ntioned prope~t t all construction will conform to all existing slate and local laws and will proceed in accordance with submitled plans. I am aware that the
building ial can r~ke is p t for just cause. Furthermore, I hereby agree that th~! city official or a designee may enter upon the property to perform needed inspections.
X J~' 7~ ~ g-'- 9'~OVJ
-Slgn~ - license No_ - Date -
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~
illy
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS 0 PERCOLATION TESTS 0
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
LJ
'1t./.10
R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
I. ~~-
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ t-
Other ......................................... $.
rye.... au
3 %"0 lf7
pai~a~~e~... ............~~~~i~;~O~
Issued -
Date ~ 9 en By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdina ana may proceed as ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allow~; construction to commence. Before occupancy, a Certificate of c pancy must be issued.
C~yPlanner
Dale
Special Conditions ij any
24 hour notice for all inspections (952) 447.9850
DATE TIME
CITY OF PRIOR LAKE ?#~y
INSPECTION NOTICE SCHEDULED
ADDRESS LA.)
OWNER CONTR.
PHONE NO. PERMIT NO. f1~
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~LATION o SEWER HOOKUP o FIREPLACE FINAL
INAL o PLUMBING FINAL o GAS LINE AIR TST
E INSPECTION ~MECH F~ 0
COMMENTS: eSl 'f'
"-.
~ J / /
1't17A/eh' d
.+RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RIOINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.l SAFETY/
f2-
lNSNOTl