HomeMy WebLinkAboutBldg Permit 01-1387
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)
2. SITE ADDRESS / L{ 7 D J CJvvr-v
~
3. LEGAL DES~IPTION t
~::ITION 0 ~~OCK fl (~--P
4. OWNER (~e) ( f (Address)
~;V'f) \,O~~~Y"'\ ~
5. ARCHITECT (Name) (Address)
1. DATE
12-{l- 0 (
c~+-
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. CJ 1- I ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
"/ _ I OI/OOS-)12.NO.OFSTORIES
PID c?- 5 c:;H:J'
~ VAl .I 51 13. TYPE OF CONSTRUCTION
(Tel. No.)
q 'S; Z-l.j<.{ 7 - 'i<f:;<-{7
(Tel. No.)
6. BUILDER ~ ROOFING & REMMtSfNG. INC.
4100 EXCELSIOR BLVD.
ST. LOUIS PARK. MN 55416
7. TYPE OF WORK Fireplace r:K) #OOCJltlO6(JJ Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
ChimneyO Mise.~P..L-~ crY'
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
Sq. Ft. Width Depth
(Tel. No.)
~lZ-~Z"S-~O{(o
Yes No
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PR~~CT COSTNALUE (7)
~ q 2:2- 5' ,.
17. COMPLETION DATE
("2-01
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 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 official n revoke this permit r just cau . AAjurther ore, I hereby agree that the city official or a designee mR enter upon the property to perform needed inspections.
X ',1 /OS-U --!L~(/-()L
'! / License No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7 G... 015
Paid Receipt NO~:;/ I (J 3 let c.(
Date I '2. -I ( -0 I By fJ7)
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 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.
SETBACKS: Required
Actual
CLOSE FILE
10/28/03 MP
Ie
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
SfP
.
fl;/~
I PERMIT VALUATION ~,~. 00
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee................................... $
Plan Check Fee ............................. $
Stete Surcharge............................. $
Penalty ....................................... $
Plumbing Permn Fee ....................... $
Mechanical Permn Fee ..................... $
R S U
City:
7'1,75
/.2C;
Sewer & Water Permit ...................... $
~a . arEe P rmi:;{;;... ................... $
is .. com Your Building Permit When Approyed.
B . Date' "\...- (l-Of
,
Certificate of Occup ncy
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
c:J COPIES
PLOT PLAN
o
ADDRESS
OWNER
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
14-70/ C!H6~ er
/
CONTR.
PHONE NO.
01-/387
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
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 GASLlNE AIR TST
o
COMMENTS:
/Z6'D r
~
/ ""I _~
/ / I O>~
\
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)
/
L-/- ~
---------
r:-t~ ~
(
~.SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~';~C/R REINSPECTION BEFORE COVERING
Inspector: 4 L/f/ Owner/Contr:
LL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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