HomeMy WebLinkAboutBuilding Permit 04-1250
7. TYPE OF WORK
New Construction LJ
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq,Ft. AI a
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also cenlfy 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
bUlld~fflclal can revoke this pe~ just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~ .-- '__("~L Cot.l5 \2t~2)lo<l
Signature License No. Date
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTlONS
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
J.~,~,
3. LEGAl. DESCRIPTION
LOT
ADDITION
BLOCK
PID zs.03Q. DZ-Z,
(Address) (Tel. No,)
~ J.
(Addres.) (Tel. No.)
(Addles.) ~.V\,E. (Tel. No,)
"2l Ol. I Lc9, -::it""
/8 "1,;;;l-2JZJI-z,/
Rs-rooflng a Porch 0
Re-sldl 0 Finish Basement D
C
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Baok
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
USE OF BUILDING
PERMIT V ALUA TION
5O~r
TYPE OF CONSTRUCTION=..\
Occupancy Group A B 6f./. F
Division (j) 2 3 4
Permit Fee ................................... $
\'a4CFf
1. White
2, Pink
3. Yellow
File
City
Applicant
PermhNo. 04 .ltSO
0......K"....~.... ..ku-"
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Helj;lt) (Width) (Depth)
/
12. NO. OF STORIES
t
13, TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
If 50C\CO
17. COMPL ION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
LI
//1 . 7 t:;
ib. !>Af
2.050
Amount Brought Forward .................. S
ParkSupportFee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid Receipt No.
City:
S U
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permlt ...................... $
~:iEil/iii~i:t;hW!i:/tr!1
Certificate of Occupancy
Issued
Date IZ. U,o':--- By
This Is to certify that the request In the above application and accompanying documents Is In accordance with the City Zoning Ordinance and may proceed requested. This document when
sigled by the City Planner constitutes a temporary certificate of Zoning compUance ancl a"ows construction to commence. Before occupancy, a cert!ficate of Occupancy must be Issued.
City Planner
Date
Special Conditions if any
24 hour notice lor all inspections 447.9850
"
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS I '5~c..o F\S~ fOv.."" {2.v - ~I\,.....q \O(p~
TYPE OF WORK ~o t> l+E:A-.c; \,J 1>uc..~
USE OF BUILDING \ I c- ,.. {{t.
PERMIT NO. ~ It' IZS" DATE ISSUED 1'Z. f~ \04
BUILDER ex..~E:N r\~ ~~"~T\'-' PHONE # c..1'1.- s'!.l- 311 \
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTiONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
!-:Fit -11..9 I I
I fJJ I
I FINAL
J
J /2 vj
/
FOR ALL INSPECTIONS (952) 447-9850
I
I
I
~t!6
'~
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
tj- /7f~O
a EXIGRADlFILLING
a COMPLAINT
a FIREPLACE RI
a FIREPLACE fiNAL
~SUNE AIR TliT_
fi.~....~l~
MJ;{t~~
PHONE NO.
PERMIT NO.
a FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
[] FINAL
o SITE INSPECTION
b PLUMBING RI
b MECH RI
[] WATER HOOKUP
o SEWER HOOKUP
[] PLUMBING FINAL
o MECH FINAL
COMMENTS:
161'~
(' Cl'V<. 0 ,J.
:t- WORK SATISFACTORY, PROCEED
[] CO ION AND PROCEED
[] CO CT K, CALL FOR REINSPECTION BEFORE COVERING
OwnerlContr:
FOR THE NEXT INSPECTION 24 OURS IN ADVANCE.
CODE REQUlREMEN18 ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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