HomeMy WebLinkAboutBuilding Permit 00-0057
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
Bf::fORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS j
J~t::,/ ill/it) k>-'7 I,'d
3. LetAL DESCRiPiiQN'- . ~
7 BLOCK .3
OA I:::..Icl.QQD H I u....5
;'j,c;;.;oo
LOT
ADDITION
4. OWNER
4ldL'
5. ARCHITECT
(Name)
~~>'I.ll.{
(Name) I
6. BUILDER
(Name)
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I 1.DATE
~_ /Y -a;.-'
R../
PID 2.5-011-0Z,2-0
(Address)
Is"5U
(Address)
_ A (Tel. No.)
WI 'IJ'wnll,l ;,1-
(Tel. No.)
(Address)
(Tel. No.)
nw)it1~
7. TYPE OF WORK
~>d./lf'li'\-;"" _S~I!{Alj''i-\.5
Fireplace CJ~ Septic CJ Deck CJ
Alterations CJ Addition CJ Finish Attic CJ
Re.roofin~ Porch CJ
Re.siding CJ Finish Basement CJ
16. PROJECT COSTNALUE
~~1?tI ~
17. COMrLETION DATE
LJ# -h-tJ(/
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 roperty 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 n ke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
::J/1J ~'b.3 . n.::1-,<I-,,;
liCense No. Date
New Construction CJ
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
11 O. CULVERT SIZE
Yes No
x
Signature
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE O~DIN'o/L-
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... <I:.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
I'
y,IO
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. ~ - ~ "l
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Hel\l1t) (Wldth) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
..ok
Side
Side
Pressure Reducer .......................... ,It
Meter Ham ................................... ,'I:
Water Meter ................................. $
Sewer & Water Connection Fee ........... ,It
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7fG. Of)
Paid ReceIPt~?(.'1ID
Date 2--14-~ By (('f)
This is to certify that the request in the above application and a...w" '~"'"'1ing documents is in aCGordance with the City Zoning Ordinance and may proceed as ~ested. This document when
signed by the City Planner constflutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
'? . ""IrO . ~
S U
Ci1y:
~
7-.9. 7 '-)
1 . '")~
ilding permit,en ff/2-",..
Date -I ~
Certificate of Occupancy
Issued
CilyPlann61
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS i']
PLANS & SPECS CJ SETS
SURVEY
PLOT PLAN
o COPIES
o
24 hour notice for all inspections 447-9850
Special Conditions if any
Dale
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
15561
- WILDWOOD
00-0057
Re-Roof
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMelNG RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMelNG FINAL
o MECH FINAL
COMMENTS:
........;;
// /
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f) //,
t-~OP-l /h~
I
DATE TIME
f/r~
U "XlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
/'
o/c
/
nr,d;/...-/,lJrY
/ -
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK" C~';JfR ~E~ECTION eEFORE COVERING
Inspector: / / / ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
JNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 01 SAFETY!