HomeMy WebLinkAboutBuilding Permit 00-0902
~~
DAT~ Ri=~I=IVEQ.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
}O .-~O
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. smr ADDRESS
1. DATE
IOI'f/~ooo
PIA. 0
PID ;)5 - 3?/1~ I)/}[{-D
3'108
Dr il/e., P"or... L" !<"e.
lJu de
wood
3. LEGAL DESCRIPTIONi?'
LOT .:::l- 1\ BLOCK
11) iUs
. r
I
1+rIrli. )
..;;< rrJ
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
;:r,_ ~ h..rqo l/vr,.J
5. ARCHITECT (Name)
(Address)
3'10'3 I-vo,,'/ f).,C/c D"",,- .P.<...
(Address)
(Tel. No.)
Cfn.' '-{'to -/'tA?
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
I - . -;) 1 I "In -'t'fo -77S0
<;066 Df'q:J''''Atu .Dr''''-, SAV"::!<-
Septic 0 Deck~ Ae-roofing 0 Porch 0
Addition 0 Finish Attic LI Ae-siding 0 Finish Basement 0
FrO....-lllf.
COkS~"(tl.':'
Fireplace 0
Alterations a
SEAT::::'
7. TYPE OF WORK
New Construction LJ
16. PROJECT COSTNALUE
Chimney LJ Misc.
8. 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 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 offici can revoke th1l> pe~juljt cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X --r:- I,J?:/T _;:)(">06011 b 3j;:J1!" 16/<;/n"
Sig08tu1e licensej(Jo. ~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLlCATlON
SOIL TESTS LJ ENERGY DATA 0
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION '-'-0 _......"
USE OF BUILDING
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Division 1 2 3 4
Permit Fee ................................... $
&7.?J::;'
~(~'71
7,1'l/'i
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .............. ................. ........ $
Pressure Reducer .......................... $
~
10'1
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ............. .... ........................ $
Paid TOI ~q~qt........~;~~i~;~O$ ,~i0t l~J
Date (0-/1-0/) ByM (~
( J
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.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
~:;~.r.~~;,~i;~.;e~it When Approved.
B Date 10 - t; - 2A!>n
Certificate of Occfncy
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections (952) 447.9850
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS <f-/r)p., W~ 'J), v-k= I .;-
- -
TYPE OF WORK Ldcr(C
USE OF BUILDING S F.D
PERMIT NO. !)O-OC)'07.- DATE ISSUED 10 Jj-2.00o
BUILDER i~,-, _ ~ Wo-ns-o
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
'FOOTING I ~$.., I N//3/h
. ,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I.~ I I
I FINAL
~
I h. I /d/J7/t'tJ
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
I
I
l
SCHEDULED /O//7,/tJo
uJooJeAdc.. T/l,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS $'1 (J ?
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING @
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: J:>6u~
/'"
l
"'-
DATE TIME
~:r.
tr eJd 2:.--
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
)
-----
o WORK 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.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/