HomeMy WebLinkAboutBuilding Permit 00-0680
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:~:\~ CITY OF PRIOR LAKE
i ~ ~ 1 BUILDING PERMIT,
I ~MPORARY CERTIFICATE OF
ZONING COMPLIANCE
JTILITV CONNECTION PERMIT
1. White
2. Pink
3, Yellow
File
City
Ap~
4-753
3. LEGAL DESCRIPTION
5
KNO!3
P,4~/~OG,g
1. DATE
C".J' 12 jov
Nt;, ~/5l>
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Permit No. ffV ~..f.~t~ m
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· ';I":~i'\'~:''''''~-:''-'-
DIRECTIONS I. i"'" .,.".. I
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
tZT
BUILDING INF.TION
11. SIZE OF STRUCTU4F- .
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
HILl-
/
+711
PID 2,5-3WZ-- 005-a.
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
o I eONN~U-
5. ARCHITECT (Name)
(Address)
l(03~08(O
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
8. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~--
7. TYPE OF WORK
New Construction CJ
Fireplace 0
Alterations 0
Septic 0
Addition 0
Dec~
Finish Attic 0
Re-roofing 0 . Porch CJ
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
17. COMPL~ IIUN DATE
I hereby certify that I have furnished infonnation on this a Iication 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 a all constructio '11 nform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~~ '71his R! Just cause urt rmore, I hereby agree fha! the city officiaf or a designee may emer upon the property fa perfo't, m~'
/ ( S/gnIIILn License No. Detlt
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
J!!!'ES 'II If!...
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION I, ~ N') .. ~C)
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee.............................. ..... $
City:
Amount Brought Forward .. .. .. .. .. . .. ..... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. ... .. .. .. .. .. .... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Plan Check Fee ................. ............ $
State Su rcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee .... .. .. ... .. .. .. .. .... $
Mechanical Permit Fee ..................... $
S1.~
,~"W
.,~
Water Tower Fee .. .. .. . .... .. .. .. .. .. .. .... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Jotal Due .............................. $ ~. ~
Paid" q q 1.3 Receipt No. :3 5r 0 '7 ()
Issued ~
Date g:: 03/cm By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning inance lnd may proceed s ~ ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate pancy must be issued.
our Building Pennit~~Il.AiP~~J
Date ./:)' -<;-~
~ -
City Planner
Date
Special Conditions if any
24 hour notice for all inspections (952) 447-9850
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO. DATE ISSUED
BUILDER "
~OTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING IN'jOR ~ j~ ~
PLACE NO CONCRETE UNTIL ABqVE HAS BEENsrtfNED
FRAMING fh,' , '?JJtJ1Ift
. \1' . I
yV}//'
FINAL
:!. ..f(' ~Ot., I
Call between '8:00 and 9:00 A.M. for all Inspections
FOR ALL -INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE nile
SCHEDULED
-::1 ,-lS-(} ((
ADDRESS
47S-3 (j/q/f"d4:A
c-t
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Gb -G$-6
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~ ~"/L
Ji!"l=INAL VC v I
D SITE INSPECTION
o PLUMBING RI
D MECH RI
D WATER HOOKUP
o SEWER HOOKUP
D PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
D FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
(~./ fk
r,
rlv
it"WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
[] CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
n1
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
I/iSNOn