HomeMy WebLinkAboutBuilding Permit 99-0054
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS 347%
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV,
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o ~UMBING FINAL
~SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
g;lMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECfW{>. O~RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: \. .~~ Owner/Contr:
CALL \w '-4i:Jo FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~ lUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
3<../78
SCHEDULED ~~~
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CONTR.
p.r.
OWNER
PHONE NO.
PERMIT NO.
99 - 5L/
/
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o FOOTING
o FRAMING
o INSULATION
~FINAL pcc.c-
o FOUNDATION
o DEMOLITION
o FIRE PREV.
COMMENTS:
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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iY'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
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Inspector: \ , Owner/Contr:
CAL"- 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.21118
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
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1, DATE
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R-/SD
2, S3 ~D7S~
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3, LEGAL DESCRIPTION
LOT (p BLOCK
ADDITION (Y\A("~i..V~
4, OWNER S (Name) 0 (Address)
. SiD ~ i-tf<Lt Y K HINr f14fl,'
5, ARCHITECT (Name) (Address)
PID
1-5 - 0'19; - 00:' -0
(Tel. No,)
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(Tel. No,)
~ (Name)
c-'~ ltfJ
E ... ~ 13VIL.D't-a...s
7, TYPE OF WORK Fireplace c:J
New Construction c:J Alterations c:J
Chimney c:J Mise,
8, PROPERTY AREA OR ACRES
Sq.Ft.
6, BUILDER
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/ 51 2dr~'o I/-KL/HlI> /J, ..;;.~)- 6 ZZ "3
'8ufR.!J5 "'i~ 'i-. (IPic... J
Septic c:J Decrzl'r' Re-roofing c:J Porch)(
Addition c:J Finish Atti( c:J '- Re-siding c:J Finish Basement c:J
9, PROPERTY DIMENSIONS
10, CULVERT SIZE
Width
Depth
Yes
No
L White
2, Pink
3. Yellow
File
City
Applicant
Permit No. qq -0054
BUILDING INFORMATION
11 , SIZE OF STRUCTURE
(Height) 8''- (Width) J {p I (Depth) c;?"
12, NO, OF STORIES
13. TYPE OFjNSTRUCTION
Rf-bGCi<. S'C/t'fW '?btuH-
14, FLOOR AREA APPORTIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
1~PRO~~CTCO~TNA~
~ //< 2'13.
17, COMPLETION DATE
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 official can revoke thi~~it ~st cause, Furthermore, I hereby agree that the city official or a ~ig~ rpay enter upon the property to perlo need in~ections,
x~--- L-r" :70 l ZO ;>.( ~ I 2 fer
/' Signature license No. te .
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION ,L):~. 00
USE OF BUILDING
RE;~
I
A/,,-
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TYPE OF CONSTRUCTION: I II III IV Ct2
Occupancy Group A B E F HIM r!J S U
Permit Fee ..........~~:~~~...1...~~.~... $ ?t.75
G, t./ ,at{
2.50
City:
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Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... ~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Perm~ ...................... ~.
Gas Fireplace Permit ....................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS c:J ENERGY DATA c:J
PILING LOGS c:J PERCOLATION TESTS c:J
PLANS & SPECS c:J
SURVEY c:J
SETS
COPIES
PLOT PLAN
c:J
~iSGtrt:;>t. Your Building ~:tr;;it ~~~ ~~rq;d, :~:;~~.~~~~~i~.:::::::::::::::::::::::::::: :
Certificate of Occupancy TO~ Due .............................. $-1(t) 1.09
Paid {(- }.09 Receipt No. ?fC/7/7
Issued CP
ThiSriS '. C"'J tha request~'n e above application and accompanying documents is in accordance with the c~:;on~ :~~~~maY pr:: ~~~, ~hiS document when
sign by the . PI er con . ary Certificar tBI11mPliance and allows construction to commence, Before occupancy, a Certificate of Occupancy must be issued,
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f . citY Planner D e Special Conditions n any
24 hour notice for all inspections 447-9850
White . Building
Canary . Engineering
Pink . Planning
Th~ ('t'nlrr of the L.kt Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments hav~ reviewed the building permit
application for construction activity which is proposed at:
Accepted
./
Accepted With Corrections
Denied
Reviewed By:
Pf;> .
REA0
Date:
Dc C- '?-I- AIV()OJ J.
Comments:
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Tht Ctnlt, of tht Lokt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
~
Accepted With Corrections
Denied (J )
Reviewed By: _ _ {/ / ()j - ~ Date: a / fOEti
Comments: -jt-~. .-to r10h "Co,")W/mil\.) 1~lit()
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"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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