HomeMy WebLinkAboutBuilding Permit 00-0604
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I ~D/;7/(}cJ
DATE I=IECEIVED
'7/1 Jf /00
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
5~ 'i?~
'(V"\(~ -rrr~
3. LEGAL DESCRIPTION
LOT / 3 BLOCK
ADDITION StYJJ. ~t\1; L,-" '"
14. OWNER (Name) -
!b;1l SdlO~f\It.-L c=,C.,<6h
15. ARCHITECT (Nama)
6. BUILDER (Name)
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.PIC
(Address) .
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(Address)
~~CO,
(Address)
4L/ q /h(,lIColl "" Av~ St'
f'VI11J-J. 5 fj Cf I il
0(0- J /.. '\- (}/f)i;l-O
(Tel. No.)
L-1f{7- 21,s-<;,
(Tal. No.)
(Tel. No.)
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File
City
Applicant
t. White
2. Pink
3. Yellow
Permit No. rf1) - () f, 0'::;
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
('e...(QoF
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS__~~
SEATS
7. TYPE OF WORK Fireplace LJ Septic 0 Deck 0 As-roofing ~ Porch Cl
New Construction 0 Alterations LI Addition 0 Finish Attic tJ Re-siding 0 Finish Basement 0 16. PROJECT COSTNAlUE
Chlmnay 0 Misc. ~ I 7 20 -? <::)
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DArE
Sq.Ft. Width Depth Ya, No 7 - Z 1-0 u
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
buildin~i~~n revoke t~i~ennit for just cause. Furthermore, I hereby agree that the city o~al or a designee may enter upon the property to perf~ ~e~ ipspectJons.
X""/ ~ /JV/~ <<..... '7;r;,/7 1/17/cJO
S~ure License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING f7 Lb At,z.
TYPE OF CONSTRUCTlON: 1 II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 "l L( ~ 7 5"
Permit Fee ................................... ct.
Plan Check Fee ............................. <t:
State Surcharge ............................. $
I, a.S-
Penalty....................................... <t:
Plumbing Permit Fee ....................... <t
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... It
MATERIAL FILED WITH APPLICA nON
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Pressure Reducer .......................... $
Meter Horn ........... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
ace Pem ,t "..................... $ Water Tap ................................... $
yl I'a ~na' 0 Building ~:'~Ft Wh I. . ~~~:~r~.~~~~~I~.:::::::::::::::::::::::::::: : vtJ
Certificate ofoccu~ncy Total Due .............................. $ ~ (..
PaId <7 c., UV Rsca,pt No )
::: to _Iy that tha request In the above apphca',on and accompanYing documents os In accordence with tha c~:~om Ordinance end mey pr~ U '~sled. Thos document whan
signed by the City Planner constitutes a temporary Certificate of Zoning comphance and allows construction to commence Before occupancy, a Certiflcattj :upancy must be issued.
City Planner Date Special ConditionS ff any
24 hour notice for all inspections 447.9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~~~
561lS
ADDRESS _ MAVES
OWNER 00-0604
- Re-Roof
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.a-FfNAL
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:
//j7/-. //
/l-co r CO~ /~ it:':
,AoRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S:~O:ECT W~ REINS::::J::::FORE COVERING
CALL 447,9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYJ
INSNon