HomeMy WebLinkAboutBldg Permit 01-0505
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
'. 'EMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 0/- 051J5
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
I n oke.. 5-4-.
1. DATE
5-;,1.,-/ -0 ,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
. 60?-O
12. NO. OF STORIES
LOT
13. TYPE OF CONSTRUCTION
ADDITION
~.o.) 35,;1.-
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
4.' " (Tel. No.)
/.J:2 -II 91-/919
Lj Or/oLe f) It .
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
M ex-- R-oo PI AilS C!fr. 9
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished 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 officia can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .;2 D 0 t.J.;;2 c:z. g I 1 Jt-.;;;1 '1- 0 /
License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
8ack
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
SURVEY
PLOT PLAN
o COPIES
o
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~i~:~i~~..~...~...~..~... $ 7 If, "1 ~
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
Ir~
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid Totaf7t;.;.bD.....~~~~i~;~O~ }jqfg 9_
Date 5- 8-5-0
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
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 as r . 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.
Crty Planner
Date
Special Conditions rt any
24 hour notice for all inspections 447-9850
"I"
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
Lf07S-
SCHEOULED &..- I/-OJ 141
If( {)()lIUO (.Ie:!- Sf-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/- 50~-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIOV /l\rflp
~NAL l""'\.~v
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:
)q1 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ FOR REINSPECTlON BEFORE COVERING
Inspector: ~ ____ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl