HomeMy WebLinkAboutBuilding Permit 00-0932
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
2;O-/b
w~oo AT
J-fu Pt/ ~
SCHEDULED
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION @D SEWER HOOKUP
bCFINAL /e..CO 0." 0 PLUMBING FINAL
/Oi;ITE INSPECTIO 0 MECH FINAL
COMMENTS:
C /ose
('
.-+-,
() -- q?, 2-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
le-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOJK. CALL FOR REINSPECTION BEFORE COVERING
Inspeclor: ~l {),M.a Owner/Contr:
CALL 447-9850 FoJTHE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
.------....-----"-----.."--------
.- -- ---------.
z- 12. NO. OF STORIES
IS J -af7(-( )
13. TYPE OF CONSTRUCTION
rer~1DI=' d- Qu.tTerS
14. FLOOR AREA APPORTIONMENT USE
"--j
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED fN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12 SITE ADDRESS 50'15
1. DATE
10-\3-CO
RlsO
;)5-
ADDITION
~ st. .sE.
d
,pnM::::J
PID
3. LEGAL DESCRIPTION
LOT {p BLOCK
If} , '--H' ..i1."", J /
14. OWNER
h'n
15. ARCHITECT
6. BUILDER
(Address)
5:)15 ~Sl-. SE..
(Address)
(TeL No.)
tDIZ-J.441-v,ILj~
(Nall\e) .
~IOSl
(Name)
(Tel. No.)
(Name)
(Address) (Tel. No.)
21~ IV. RIVclC. K.1~Clle. q~_
BLl el>Jsv ILL'C, t..l>J .55331 11/..1q
Deck ("] Re-roofinQ)!( Porch ("]
Finish Attic 0 Re-siding 0 Finish Basement 0
""I~T Ct'MlZ. Tlm~~
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
Fireplace ("]
Alterations 0
WCX>9 z. /
:VlL>.(X)
1.
2.
3.
icant
File
Permit No.
BUILDING
11. SIZE OF STRUCT
(Height) (Width)
(Depth)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTF
SEATS
16. PROJECT COSTNALUE
$~qlP8. ~
17. COMPLETION DATE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
SQ. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the best of my knowledge tl\le and correct. I also certify thatl am the owner or authorized agent for
the above mentioned property and that all constl\lction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUilding~'cial 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 insp ions.
X "'l~ RClM ,;(D1t.l..,331.:>
l) Signature license No.
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .... ................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALVA TION
USE OF BUILDING 1-<.e Y' (')() r
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
0,",'001234 ,If 7'
Permit Fee ................................... $ ~
Plan Check Fee .... ......................... $
City:
State Surcharge ............................. $
Penalty. ............. ............ ......... .... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/-d5
MATlERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
Cl
PILING LOGS 0 PERCOLATION TESTS ("]
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
Cl
7/;.-
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid ,1__ - R.ce)'J.~o
Issued Oat" IJ -I? _I) () By ~ (1-1../ ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proc~equested. 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.
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Ap~tlon Becomes Your Building Permit When Approved.
By I/f Date
Certifi"-'e of Occupancy
1/;,..-
24 hour notice for all inspections 447-9850
SpecialCondrtions~any
City Planner
Dale
.1"' _.