HomeMy WebLinkAboutBuilding Permit 00-0802
~1
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
:t
It;
1. White
2. Pink
3. Yellow
File
City
Applicanl
tJ'. (p .00
Permit No.
00 {)80Z-
I DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN 0
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) / ~ (p .. 0 0
12. SITE ADDRE3SS 5/':) I
..., 8/lSSJ1/0oD ~j~(j.::;,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
4-
LOT
BLOCK
iIIIllLOWS
Z-
~
PID 2.,;;?-//t) -tJ08-()
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER
15. ARCHITECT
6. BUILDER
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
11Me;~
e,tJNSTe-.
, /
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Fireplace tJ
Alterations 0
Septic 0
Addition 0
Deck 0
Finish AWe 0
R~~~~ Porch 0
Re-Sid"'~ Finish Basement 0
Chimney 0 Misc.
a. 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 of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the abo entioned p~ope d 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 ff ial n rev . p~st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pe~ ne~~d i actions.
X a,~ 7-~ 0
.. -;r Signilll.j~ License No. ( Dale
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Baok
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
dSRf/L
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
L. SZJ?J.d?/
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... It.
S U
City:
Amount Brought Forward .................. $
Par1< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ............. .......... $
Sewer Tap ................................... $
$
i4.7s
Plan Check Fee ............................. $
/.?~
State Surcharge ............................. ct
Penalty......... .............................. <I:
Plumbing Permit Fee ....................... It
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ,.,............. .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ....................,. $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ -"7 &> . C/l.I
Paid -; (g . rf?) ReceiP~tl13e 2-'1/
Date q. (p. oU By--1iPL.
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoniflg Ordinance and may procee9ls 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.
::~ A7~ ~~i~~.~e:itWhW~f7'~~
By ~ Date /'W
Certificate of Occupa4
Issued
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
OWNER
359/ &ssl.IJCOcL
CONTR. ~
(jf')-'?D~
PERMIT NO.
ADDRESS
PHONE NO.
o FOOTING
o FOUNDA nON
o FRAMING
~SULATION
INAL
SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
~M;~;:P <i-~icLe-
(-:P-?~ ~ k
,-
/wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
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/
INSHOTI