HomeMy WebLinkAboutBuilding Permit 00-0714
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 3q 3 4
OWNER
PHONE NO.
o FOOTING
~NDATION
o INSU;:::;;~~ ,
)ill FINAL
o SITE INSP
SCHEDULED
DATE TIME
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CONTR.
PERMIT NO. DC - 7/4
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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)l3WORK 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!
INSNOTJ
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QAIE..Pt::f';Cl\ll=n
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicanl
75/IS/00
Permit No., 00' i 14
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (PleaSe Print or Type and sign at bottom)
12, SITE AD~RgS~ /.'
."J I T7 ~/ld~'/1J/) <:Sf ()fA.)
3, LEGAL DESCRIPTION
I L/ BLOCK I. \
G l'U--(\ I--\eJ ~ y),h \ ~ \-
140W~ ttu (Na~IGh ayd <;' (Address)
15, ARCHITEcU
6. BUILDER
'~71s1 00
j
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
ADDITION
PID as-/Oc)- 0 1(,- 0
A.olrLn
13. TYPE OF CONSTRUCTION
LOT
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT"
My! () 5(',
7, TYPE OF WORK
1700 h /1 f1
Fireplace CI _I Septic CI
Alterations CI Addition CI
IfCf.a ~ 3 tlf.:L
SEATS
New Construction CI
Chimney CI Misc.
\a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth 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 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 can revoke this penni! t~rthermore. I hereby agree that the dty official Dr a designee may ente.>JIPon the property to pertm needed !,spectjons,
X ';;(cv:::ldtl..", A~ _ ;:;;OI;).'3,/'/~ "'IISleYJ
Signature Ucense No. Date -
DeckCl
Finish Attic CI
Re-roofing IX.... Porch CI
Re-siding 0 Finish Basement 0
16, PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
- SETBACKS: Required
Actual
Front
Back
Side
I MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS Ll SETS
SURVEY Ll COPIES
PLOT PLAN Ll
USE OF BUILDING
~nb
A1 r<:
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION _
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division1234 I'lS
Permit Fee ................................... $~
Plan Check Fee ............................. $
City:
Amount Brought Forward .................. <::
Park Support Fee ........................... $
SAC ...................,..............,..,.., $
Collective Street Fee ....................... $
Sewer Tap ................................... ~
.
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ It
Other ......................................... $
State Surcharge ............................. It
1.;;25'
Penalty ....................................... It
Plumbing Permit Fee ....................... $
Mechanical Permit Fee .................. ... $-
Sewer & Water Permit ...................... $
Total Due ......,...,.....,............. $ '7 h . C;U
Paid 710. to Receipt No.
Issued 'Date ~/1;i/gl By f~)
This is to certify .that the request ~n the above applicatio~ and accom~anying d?cuments is in accordance. with the City Zoning ~rdinance and may p~.eed a re uested. This doc~ment when
signed by the City Planner constitutes a temporary Certificate of ZOning compliance and allows construction to commence. Before occupancy, a Certificate f pancy must be ISSUed.
City Planner Dale Special Conditions if any
uilding permitWh~~)
NLDate ,., / ,./ ;UV
24 hour notice for all inspections (952) 447-9850
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