HomeMy WebLinkAboutBldg Permit 01-0934
(Address) (Tel. No.)
59'1 J. H /1)'bvv 0-4A:s CII~.. ~ "'/1\
~ (4d~}b q~2~6~'iJjr;7'
(Address) ?:;f... S1'""' (Tel. No.) 95-,), - 15. NUMBER OF OCCUPANTS OR SEATS
ItJd!;;,j~:AI_ a~3-Js~1;
I'V~r'---:'~ S53l13 7
Septic 0 Deck 0 Re-roofin9'S( Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
~J;7 !of
2. SITE ADDRESS
5qJ..j~
H-lD'1[,A/ t},4}-6
C I ~C.t-L
3. LEGAL DESCRIPTION
8- iJcdJl~::JK ({~
LOT
PID
f)~ /673-{)tJn-U
Is. +-
ADDITION
4. OWNj) A-,II/ (Na:s- ~ y
5. ARCHITECT (Name)
6. BUILDER
(Name)
&~
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 o. CULVERT SIZE
Yes
No
;;}.JJ- "/17 I
1. White
2. Pink
3. Yellow
File
City
Appli~"
Permit No
BUILDIN
11. SIZE OF STR
(Height) (Wi
(Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
b'1 J 8'"
17. qM7JC ~~rE
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
:u~rev~e. this permit for iust ~se. Furthermore, I hereby agree th13'S~cial or a designee may enter upon the property to pe'tJ~~;~ni
~ License No. , Date '
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................ ........ ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
7L/~1C;--
Plan Check Fee ............................. $
State Surcharge ............................. $
/1" ()-.S-
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... !I'
This Application Becomes Your Building Permit When Approved.
By Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Other ......................................... $ -0
Paid TW7 G..:O'O......~~~~i~;~O~ :JJ tc%
Issued () C:. ~I
Date ~,.. ;).....Lj -0 J 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 a r uested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 0 upancy must be issued.
Certificate of Occupancy
Crty Planner
Date
Special Conditions rt any
24 hour notice for all inspections 447-9850
CITY OF PRIOR LAKE
INSPECTION N,;)TICE
SCHEDULED
DATE TIME
/O.3rOI A.T...
ADDRESS
~?14z H/OO~N OftKs 7l<..
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
.9/INSULATION r:"
JlI'.. FINAL (GtJO r
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECHIL
1"'/1
~i}
~
,
iJj
;"'>-'7;l:1:
"Tl"
~
O/~15'f
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
!J1 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: '~ 1 Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI