HomeMy WebLinkAboutBldg Permit 01-1273
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
Permit No.
* \ l 4 3~
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
Llq /3 AlE B!ac4 )f.
BUILDINGtNFORMATION
11. SIZE OF ST~URE
(Height) 1WIlIIh) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
ADDITION
~1 BLOCK
fI.J2Lq..d- 0
12~~
PID.25 "'33/- O()~-O
Ibd-.
13. TYPE OF CONSTRUCTION
4. OWNER n (Name) (Apdress)
K Oit! "l M ClIlI.u~v ' c::; 1YlJm I'hL
5. ARCHITECT (J (Name) (Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
R~oop ~~)((l&rfJ' qso~ (r;;~da!t,ltw-f-M. ~~J-oJggf-ilfro
11,liJ<lmll1.~ HN )S'l~
7. TYPE OF WORK Fireplace 0 SeptiC 0 !tick 0 Re-roofing)( Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 7 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
17. COMPLETION DATE
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 above mentioned pro tion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can rev ermore, I hereby agree that the city official or ~esi~n;e may enter upon the property to perform needed ~ections.
X .-If: d. V / l/ / q /7) /1- ,'J - 0/
License No. Date
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SETBACKS: Required
Actual
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~~..~...~...~..~... $ 7 'I. 7 r
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... .. ... ... ... .. ...... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn....... ............. ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... il'.
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
1.1".r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
:::::tiePrJdJ.i1....~tya,~~~J L
By ~~ding~:tr;:~_ V
Issued
Paid Tota'~.:.{ii).......~~~~i~..
Date 1/-7-DI By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce and may pr
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certilica
Certificate of Occupancy
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
OWNER
4913
BEACH
01-1273
Re- Roof
ADDRESS
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA liON
o FINAL
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 AfR TST
o
COMMENTS:
f:LC5= FILE
19';~Co ~ I Co. ':>\In, Build;,,~ Inspector
-.OfT ? 7nn':l
o 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!
INSNOn