HomeMy WebLinkAboutBuilding Permit 00-0045
6. ~,UILDER . (Name) (Address) . 'ptfc::L q/C)-
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~~:~:;~ru~:::O ~'=-o,~ r.:dd'fltJr/t1fYirt;:.",::,:: ;~1&S~~TZ'[\~ 16. PROJECTCOSTNALUE
la, PROPERTY AREA OR ACRES 19. PROPERTY DI~NSIONS ]1(1, CULVE/n SIZE 117. COMPLETION DATE
Sq. Ft. Width Depth YElS No
1 hereby certify that I have f~miSh " infonnation 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 aba mentioned property that construction ill confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding i' yoke t. e~it f h8nn: hereby agree that the city official or a designee may enter upon the property to pertor ~~~O()
"\; Signature license No. Dale
~~
DATI= RI=r.r=I\'~n.
~/ ~/ 00
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)
l't:'j7-0 0
2. SITE 1pDRESS f" ~ () ~ I A.f) () r
1(1u44 tV I) Vi dAL r;-I/Y, (j.L . P.I~f)
3. LEGAL DESCRIPTION II. l~ g (ole ~ a>JL ..IX d.LfJ-t \.U...e N O/+/r.- YI4.
LOTS/ -t-S:J.. L.(J.>N'- BLOCK " PID 76J..f6-O!iJ-t'J
ADDITION ~ L()f .
t-a r It l/dUO~ LILt Eadp, (/h 0 'JJFff ~8~
(Address) I.J (Tel. No,)
~~3 t-(~
5. ARCHITECT (Neme)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No,
oc.<./..c;-.
BUILDING INFORMATION
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
SEATS
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLlCA nON
Amount Brought FOlW8rd .................. It
Park Support Fee ........................... $
SAC ......................................... 'I:
Collective Street Fee ....................... 4:
Sewer Tap ...................................4:
$
Pressure Reducer .......................... $
Meter Horn ................................... ~
Water Meter ................................. $
Sewer & Water Connection Fee ........... lI:
Water Tower Fee ........................... $
Water Tap ................................... <I'
Builder's Deposit ............................ !to
Other ......................................... ~
TOlal Due .............................. $--7/P.OO
Paid '1(.,.00 RecelplNo. <<:(o-,qS
Date '2 - <-{ - ~ay ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as 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.
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
USE OF BUILDING
~,
,
JI /R..
2.SbO, ('"n
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II lit IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
,t.{.7S
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I.~S-
Sewer & Water PermIt ...................... $
~~asFi ~~. ~.. ......~~;I~i~~.~..~ttWh.~~roV.d
B Oat. 7- 'f 2000
, .
Certificate of pancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS a
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o
o
COPIES
16044
EAGLE CREEK
00-0045
Re-Roof
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
// /)
/4or
/ )'
ffop;.'
SCHEDULED
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
a~pe.-:;.)'\
/J/
'7're
DATE TIME
f~~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o;C
/
d.
qYc;/JA.
(/
/
A WORK SATISFACTORY, PROCEED
I 0' CORRECT ACTION AND PROCEED
o CORRECT WOFJ-,17'Lr' REINSPECTION BEFORE COVERING
Inspector: .YU/ L ) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.l SAFETYI
IN.fNOn