HomeMy WebLinkAboutBuilding Permit 00-0377
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
(Add,eSS)(.. ''-'1. (Tel. No.) .ILI'
Go,,-\- >"'-'P1..1oU W.?-\~"> ~Ql'v- "1(.."'1"\
I t)1'_ '::;'P"~
Re-roofingJ( Porch 0
Re-siding 0 {Finish Basement 0
.5.0,,\'0
\\o?,-
0% ~-,
BLOCK
5- r b~.e...,\
3. LEGAL DESCRIPTION
W 'L'i qo'
ADDITION r (J, .tV ll'\
LOT
4. OWNER
(Name)
m~""'\.....
(Name)
I'Y\o. -I" ,,~
15. ARCHITECT
6. BUILDER
(Name)
\ , ''"') ~"'"'
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
1. DATE
IC\.
\'""'')'1 ?C)
'S-\-
sf:"
/-'.
/0
1. White
2. Pink
3. Yellow
File
City
Applicant
I ...1
PID ;:;1").-
A-{)(\N
bit- 00..:2.-6
Permit No. ( fb - 0 -:\71
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth)
(Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
1l.c!".,-r ~
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PJilJECT COSTNALUE
~ 4'?,S ,pO
17. c(JMPLE1ION 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 true and correcl. 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
buHd;ng official can reVok~it 1m j~se. Furthe,mme. I he,eby agree that the city official 0' a designee may ente, upon the pmperty to pertonn needed inspections.
X " ~ l 104Q~ \ 0, r<"G'i aZ>
alure License No. Date
I
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING 1,-
lLIIJ.S.
i:Y1/(.
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee ...................................!I:
-rzLf. ,7~
Plan Check Fee ............................. $
State S",charge ............................. $--.1... :::J,<)
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
(Address)
.!; c:.4o
(Address)
(Tel. No.)
u.~ ~-f- LI'-l,O--"tt..-UO
(Tel. No.)
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY OATA LI
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY LI
SETS
COPIES
Deck 0
Finish Attic 0
FOR ADMINISTRATIVE USE
Back
Side
Side
PLOT PLAN
LI
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Pressure Reducer .......................... $
Meter Ham ................................... $
Water Meter .................................!I:
Sewer & Water Connection Fee ........... It
WaterTowerFee ...........................!I;
Gas Fireplace Permit ....................... $ Water Tap ................................... ~
This~i?Wn Bj~~~t ~ing permit~r.l,rfR~ved. Builder's Deposit ............................ It
By ~~U..'VII_/ Date Iff/\ Other .........................................~,
Certif;cafe of Occupancy I paJ ~~DU~;'O................~~~~i~;~O. :~t ~c;
Issued I h . .J .J
Date ~ I'll CO By ttf\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 a uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows .::onstruction to commence. Before occupancy, a Certificate 0 upancy must be issued.
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
.:>U4U
ADDRESS HOPE
00-0377
OWNER _ Re-Roof
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
SCHEDULED
DATE TIM.E
2}f~tL'
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
-
////~ J/
/(,oo?' (d-/Jk N
/
,...B-wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:s::~:'ECT WO~:INS::::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COPE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
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