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HomeMy WebLinkAboutBuilding Permit 00-0712 ~1 124TC RCr.~ CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. White 2. Pink 3. Yellow File City ApfIl- 8.14-- 00 Permit No. 00 .D1/~ DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 12. SITE ADDRESS 5",,\ 4 S tI-\(:>~ C9A~S 3. LEGAL DESCRIPTION 1.0ATE B-I4-'OO BUILDING IIII'ORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) Gl~. 12. NO. OF STORIES LOT o PID BLOCK I-h,:>l'>~ OAic.s I ~ A-,~~. - . (14. OWNER 1 (Name) ../)-&.-1"\....... (Address) I" 1 Y11?1/l'I?fLtr-K\ IT 'At. \~ '\ 15. ARCHITECT (Name) (Address) 6. BUILDER (Name) (Address) 13. TYPE OF CONSTRUCTION ADDITION (Tel. No.) Q:;J J-Itii U2.,\ '/ (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANT~ 7. TYPE OF WORK New Construction 0 Fireplace 0 Alterations 0 Eo~t:=SS Septic 0 Deck 0 Addition 0 Finish Attic 0 LoU II'.IDo....J Ae-rooflng 0 Porch 0 Re-siding 0 Finish Basement 0 SEATS 16. PROJECT COSTNALUE Chimney 0 Misc. 8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE Sq. Ft. Width Depth Yes No I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for the above m d property th t all c truction will conf to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building 0 . lal 0 i ~h ore I hereby agree that the city official or a designee may enter upon the property to perform~~/JJ~ec'!JrJ .4 License No. 'f"Date ) 17. COMPLETION DATE FOR ADMINISTRATIVE USE SETBACKS: Required Actual MATERIAL FILED WITH APPLICATION Front Back Side Side SOIL TESTS o ENERGY DATA Ll ees A/"e.- I OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION PILING LOGS 0 PERCOLATION TESTS 0 BUILDING DEPARTMENT VALUATION USE OF BUILDING PLANS & SPECS 0 SURVEY 0 SETS COPIES 2, Sl)n 00 . PLOT PLAN Ll TYPE OF CONSTRUCTION: I II III IV Occupancy Group A B E F HIM Division 1 2 3 4 Permit Fee ................................... $ V R S U City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ . 1~.1S Plan Check Fee ............................. $ State Surcharge ............................. $ Penalty ....................................... $ I . "'Z.b" Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Pressure Reducer .......................... $ Meter Horn ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee "......... $ Sewer & Water Permit ...................... $ This By Water Tower Fee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ it. Other ......................................... it. Total Due .............................. $-2Jp. () 0 ReceiPt~3B z.o G- Date p,./4-.no By !JUt-.. 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 ~requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to """ ,.. ,..,.. ....a. Before occupancy, a CertificateTof 'Occupancy must be issued. .......... $ GasFi lding Permit When Af.PJ:veP...... Date t!>. ~-oo Issued Paid CilyPlanner Date Special Condilions if any 24 hour notice for all inspections (952) 447.9850 PRIOR LAKE INSPECTION R~~q~~A\C5 DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS TYPE OF WORK E.G(Z---..esS .L-UIM)o....v USE OF BUILDING f20; I"t;( rC /. PERMIT NO. 00 r"1 12-. DATE ISSUED eJ (4/00 BUILDER 1:xvc.:. ~f>E::r2-TMAN,.J NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT C,f2. , ~ I I PLACE NO CONCRETE UNTIL ABq,VE HAS BEEN SIGNED , FRAMING I 6;. I r(Z-S/ /:Iv INSPECTOR DATE , FINAL I #?- I 1'- I- c1V Call between 8:00 and 9:00 .(M(for all inspections FOR ALL INSPECTIONS 447-9850 1 I J " ADDRESS SQ45 DATE TIME 01 J._ Ir~:7_ SCHEDULED ~ ~ ~ J.k~ O~ Q. CITY OF PRIOR LAKE INSPECTION NOTICE OWNER CONTR. PHONE NO. PERMIT NO. O-II~ o FOOTING o FOUNDATION o FRAMING @ o INSULATION .....-li4INAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: Fl"lq IL~ vv k) I ND~ ~ ~ -~,r-L. :;;~~- r..,-- ,"t1 _ ., )~ ~ X - ~ , 'f:. WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~l Owner/Contr: Inspector: I CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ lNSNOTl