HomeMy WebLinkAboutBuilding Permit 07-0997
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/40>y 4~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~/)
/ /
( (
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
r oaC-
/~,
l U:>-e
DATE TIME
I D.-]! 'ZfI
7r-f4;
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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/ '\
0,,- )
/
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ;AL~REINSPECTION BEFORE COVERING
Inspector: J /l /" Owner/Contr:
v I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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
I L1 O_.;s <;? ~ IA tCf~ 1 .9 ~ t- n/ (;
3. LEGAL DESCRIPTION
1. DATE
i c2 -I () .- 0 ')
LOT
BLOCK
PID
ADDITION
4. OWNER (Name)
ore f'e ~ Q.
G{'}iA.'~ ~
(Address)
j /,.-J () 3 :y
(Address)
..J
5. ARCHITECT
(Name)
6. BUILDER .~ (Name), f.J ',,. _. (Address)
A-fY'.en CCt41 B 1,\\ \ 'VlP1,y (ontf et:ctO'-\. J
). 9 GO "'ju..dcct'Qt! Ac.c, bCl1/YSV t l/-e
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft
(Tel. No.)
CfS)..-70 7 -- G959
SS 337
Re-roofing " Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
\'1-' ~B
1. While File
2. Pink City
3. Yellow Applicant
Cf5CZ'CfV7 ~~-7~..
Permit No. q fPOrl
07 -O~~7
BUILDING INFORMATION
11 . SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONST~UCTION
f\-e. - r 0 o"f
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
tit ~11,6 5
17. COMPLETION DATE
10- 3/- 07
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 ofpej.~ca revoklJ. thi~ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X l f. "if. ,~1;:)a20~ :2 01 <O13~? 10 -/(" - 0 7
- Signature License No. Date
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.............................. $
FOR ADMINISTRATIVE USE
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 ~
Occupancy Group A L!) E F HIM!!SJ S U
Division (f) 2 3 4
Permit Fee ................................... $ 7 L(. 7 S-
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I . 25:"
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By ~r~ ~Date !O(/fo 1'07
Certificate of Occupancy I
Issued
Paid
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
$
7~, OD
Receipt No.
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.
By
Crty Planner
Special Conditions rt any
Date
24 hour notice for all inspections 447-9850