HomeMy WebLinkAboutBuilding Permit 99-0082
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATe
1J.~8-17
-=--.:.-.!..
L.~_
--
ADDRESS
SCf;lEDULErJ
TIMe
Nt31 !.. ~
OINNER :---- CONTR.
PHONE NO. ___ PEIlIIIT NO.
o FOOnNG 0 PLU"'BlNG '"
o FOUNDATION 0 MECH RI
o FflAMING 0 \VATER HOOKUP
o INSULA nON . -/,f\ 0 SElNER HOOKup
)/( FINAL AQ -~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FIN L
Q
~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
0_ __
COMMENTS:
--- c.
-
~
ORK SA TISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WoRK, CALL FOR REINSPECTION BEFORE CO"""'NG
'nsPectoo ~ ","""riCon'e ~
CALL ..,..... FOR THE NEXT INSPEcnON 24 HOURS IN ADVANCE,
CODE REQOlREI!tENTsARE FoR YOUR PERsONAL HEALTH & SAFETY!
INSNOTI
I}} ?
'\,
1. DATE
r2-/7 Jqg
12.-\
PID Q~1S- 31 4. -Oi~-CJ
4 Tl.-\ A--D 0
(AddreSV _ . (Tel. No.)
\ '4 (.087 La oaLU 1. La..nr, "'fJJ 7 -/.oOt.J 3
(Address) (T,el. No,) 'CL.;7" ....
/2 0' ~ \/fLLh ->7.7:> I
(Address) t.~ /f"l - fl'el.-No.) ~qo _ 15, NUMBER OF OCCUPANTS OR SEATS
'3~ Larc lodustra.\ ad. 3900 OCCUPANTS
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2'\SfI~~7 L(lnd(ll.L
3. LEGAL DESCRIPTION
4-- BLOCK 4-
~~;A~ ~IL-l-S
LMC,.
LOT
ADDITION
4r3W~E~
J5Q))\ ()
5. ARCHITECT
i~~am~)\
~Tr f rt-
(Name)
6. BUILDER (Name)
\-\0.( \ -z<x) EJ'te(\OlS
7. TYPE OF WORK
New Construction CJ
Septic CJ
Addition CJ
Deck CJ
Finish Attic CJ
Re-roofing CJ Porch CJ
Re-sidin9)( Finish Basement CJ
Fireplace CJ
Alterations CJ
Chimney CJ Misc.
8, PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10, CULVERT SIZE
Yes No
1(j. t7D
1. White
2. Pink
3, Yellow
File
City
Applicant
Permit No.
qq -010812
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
1~NSTRUCTION
14, FLOOR ARE~PORTIONMENT USE
SEATS
16, PROJECT COSTNALUE
~050. 00
17. COMPLETION DATE
I hereby certify that I have furnished 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
buil 'ng off ial can revo e this pelit for ju t cause. Furthe ore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins actions,
X ~ ~/~S
Signature License No, Oat
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... ~
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
Side
Beck
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I " III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
-z~. !~
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... ,.
1- LS'
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
SURVEY
PLOT PLAN
CJ COPIES
CJ
Pressure Reducer .......................... ~
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7 b_ - Receipt No, <'43'1 <:.>
Date ?/~ I q q By ('--Of~
This is to oertify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinanc~ a~d 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,
Certificate of Occupancy
s ou~uilding Permit When fe,.prov/d,
/ '\. Date 1..- ~ I q ~
~ 'f
Issued
City Plenner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
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