HomeMy WebLinkAboutBuilding Permit #99-0311
CITY OF PRIOR LAKE
INSPECTION NOTICE
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TIME
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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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o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o FOOTING
o FRAMING ~
o INSULATION ... '
FINAL, J)f; "-
~FOUNDATION
o DEMOLITION
o FIRE PREVo
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PRqCEED
o CORRECT WORKMC LL F~ \ REINSPECTION BEFORE COVERING
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Inspector: ~l \' Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
T
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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OWNER
y/ ~ l' IC.-~ ~o IJ".
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
/9-3/1
o FOOTING
o FOUNDATION
o FRAMING
P. INSULATIO~ /)
~ FINAL c::adl
o SITE INSPECTION
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 GASLlNE AIR TST
o
COMMENTS:
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~ Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
INSNOTI
'1't . S 7/
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 t/ wi ~. ..k1 4 .~fIj (<( j
3. LEGAL DESCRIPTIO~ I ~J.:\ . .
LOT \.. "'5 BLOCK ~ PID ~ 5 I 31>)( j () U:;. ,1
dJ} cL .Af1 d 'A) 1,') ~'P' Ilj 4~ .
4..~ER (Name) (Address) (Tel,~~.).-~ (pJ-:S..,
tn, c...\t\CI.€ \ 1'\ ,C'rlc.L\.p. l.t 1),,4 ~~~ 1~1'c.4R (lJ
5. ARCHITECT (Name) r (Address) ,J (Tel. rfo.)
DATE RECEIVED
IIR'_
ADDITION
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
~.qq-311
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1. Dl\TE
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name)
~ez-F
(Address)
(Tel. No.)
Wt fJ/~~~C:.-~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPEOF~K
New Construction D
Septic D Dect<Jt
Addition D Finish Attic D
Re-roofing D Porch D
Re-siding D Finish Basement D
SEATS
16. PROJECT CUi) 'l"AWe '
Fireplace D
Alterations D
Chimney D Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
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 a d that all struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building o.J!iIJial ~e this e It for' s cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perto#de;1 /!spections.
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S License No. ~
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ /); i .5' I
Total Due .............................. $ '-"I '-1 ~
Paid ~ 4. set Receipt No. ~"4'~;
Date +- r t Co {10, By (2..0 (4-
T,fJ' ~~at the uest in the above application and a. ccompanying documents is in accordance with the City Zoning Ordinance anJ may proceed as requested. This document when
s' ed I 0/1 ~I -c tes te porary Ce~r:r-I1 ,mPliance and allows construction to commence. Before occupancy, a Certilicate of Occupancy must be issued.
City Planner 0 e Special Conditions ~ any
24 hour notice for all inspections 447-9850
Front
Back
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ->>S 811';
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
" fo'f'Y!.. t1[")
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TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A B E F HIM 'W S U
Permit Fee ..........~~~~i~~..~...~.~... $ S'{.. ./ S-
S'L,.~1
.10
City:
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
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V. '>: \(
V
Sewer & Water Permit ...................... $
";&~rl):li.~:::~".W't.,7'-'t7
Certl cate of occupanrJ! /
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS D ENERGY DATA D
PILING LOGS D
PLANS & SPECS D
SURVEY D
PERCOLATION TESTS D
SETS
COPIES
PLOT PLAN
D
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .........................................$
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
~
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Th~ Crntrr of thr Lakr 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:
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Denied
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Accepted With Corrections
Accepted _
Reviewed By:
Comments:
Date:
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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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The Crnler of 'he t.ke Counlry
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:
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Accepted
Accepted With Corrections ~
Denied _ /
Reviewed By: / //7f_ /l~
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Date:
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Comments:
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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.1I
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The Ct'ntt'r of tht' Lake Country
White - Building
Canary - Engineering
Pink - Planning
mJlLDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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Accepted
Date:
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Comments:
"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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