HomeMy WebLinkAboutBuilding Permit 00-0307
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5/5/00
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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White
Pink
Yellow
File
City
Applicant
Permit No. () (J -
CJ36 7
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2SITEADDRESS1c") / 0 pi'1.G....~v /Jc.-c
1. DATE
s..- S--... 00
>h
BUilDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID
7 <:-C/t'J2-- ()fl--O
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
(Name)
f_/",s
(Address)
/6 'J?O
(Address)
7 q~,./
q;77
(Tel. No.)
/I-/J_1 ~-
, .
(Te,NO.)
t-. ~ ""'-I'
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
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r. /".
5. ARC~CT
....-
6. BUlL.: ER
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction CJ
Fireplace 0
Alterations LJ
Septic 0
Addition 0
Deck 0
Finish Attic 0
Ae-roofin~ Porch 0
Re-siding 0 Finish Basement LJ
SEATS
16. PROJECT COSTNAlUE
Chimney LJ Misc.
8. PROPERTY AREA OR ACAES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 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'Surthe~, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
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t--- I Signature - I' Ucense No. - Dala ~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual'
Front
',OJ<
Side
Side
MATERIAL FilED WITH APPLICATION
SOil TESTS rl ENERGY DATA rl
PILING LOGS LJ PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
e:&5 A/~
;
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2'575V. crv
PLOT PLAN
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TYPE OF CONSTRUCTION: 1 II III IV V
Occupancy Group A B E F HIM A '$ U
Cily:
Amount Brought Forward .................. $
Park Support Fee ........................... Ci::
SAC .........................................!I:
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
~q. 7"-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty...................... ......... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.2-5
Sewer & Water Permit ...................... $
Pressure Reducer ..................."..... <I'
Meier Horn ... .... .... ........................ It
Water Meter ................................. $
Sewer & Water Connection Fee ........... ~
Water Tower Fee ........................... $
Gastibi-_~mm,
This Belding Permit w~ ~proled.
By Data 7 c:;:; r.J7-.-
Certificate of Decu/an I
Water Tap ................................... $
Builder's Deposit ............................ $
Other .........................................!t,
Total Due .............................. $ -;1(". OU
Paid Ifn. 0 U ReceiPt~, ~ 7 c;,
Date skicrU By "If< ^--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordi"'nce and may proceed ei requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificat/;f Occupancy must be issued.
Issued
Cijy Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS 16390
- ALBANY
OWNER 00-0307
Re-Roof
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,.B1'INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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tfWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH de SAFETY/
INSNOrl