HomeMy WebLinkAboutBuilding Permit 00-0795
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
9-5.00
Permit No.
00.0195
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
1. DATE
9.5.00
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
4-/45
c.J
I
HI I.d .
CJ eC!-I-b
3. LEGAL DESCRIPTION
..3
12. NO. OF STORIES
LOT
BLOCK
KN /)13
PID...2.$ - 2,. 0 I-
I=; TH
002..-0
13. TYPE OF CONSTRUCTION
ADDITION
140 OWNER
\5. ARCHITECT
6. BUILDER
(Name)
su6
(Name)
(Address)
UIPP672--
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
1fP6)C
7 (It; oRIcLt Dr
87/-1117
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction [""J
Fireplace LJ
Alterations 0
SepticLJ
Addition 0
DeckLJ
Finish Attic LJ
Re-roofingX Porch CJ
Rs-siding 0 / 1inish Basement [""J
SEATS
16. PROJECT COSTNALUE
Chimney LJ Misc.
IS. PROPERTY AREA OR ACRES 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 ot my knowledge true and correct. I also certify that I am the owner or authorized agent tor
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
build~!lg.official can reVO(:(is jUilrmit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x~.r-#..,.~_., } ~~ _~_
- v ~.(.~
17. COMPLETION DATE
License No.
0.10
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS LI PERCOLATION TESTS LI
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
R65 ,q / K:...
~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
2,,5lJlJ (/I)
PLOT PLAN
LI
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. ~
Park Support Fee ........................... $
SAC .........................................4:
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
74,15
Plan Check Fee ..................... ........ $
State Surcharge ............................. !t
Penalty .............. ......................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I. 2~
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ... .... ............................ $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... cr
WaterTowerFee ........................... $
Issued
Water Tap ................................... 'I'.
Builder's Deposit ............................ .II:
Other ......................................... <I:
Paid T;Ce. .(jij............~~~~i~;i)/~V~
Date q ,,r-, to By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni~g Ordinance and may proceed ~quested. This doCument when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificatel>f Occupancy must be issued.
g Permit W~en Ap~ved. c)
ate 70:).0
This A
By
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
rA~o/
ADDRESS
4145
CJ
00-0795
Re-Roof
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
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 GASLlNE AIR TST
o
COMMENTS:
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{ C5~ K:? /e. -re..-
I'
1
I,
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEEO
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOr.