HomeMy WebLinkAboutBuilding Permit 99-0108
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEO /0 -/ S- -97 J I T,
v<<~ lj
ADDRESS ;I~O() 2
OWNER
CONTR.
PHONE NO.
PERMIT NO.
91- /O?
o FOOTING 0 PLUMBING RI
o FOUNDA nON 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
b SITE INSPECTION ~ 0 MECH FINA~ ./
COMMENTS: <~. - > ~ '
lu J
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ ~ hra I~ ~
('~ ~ ~
.. ,~
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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
..' 88
Permit No. !it{ - CJ~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SIT/~;;? ~~
3. LEGAL DESCRIPTION
LOT ~ BLOCK;2 ,
ADDITION IJ)rj{11 fftli7:!llrft /2T AcidJl.
4'k!iJ-uJ/)!me)/~y '7/;hhl2t
*Hq
I I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID J()- J4L/ -c{;€'- ()
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
~ ~ -/("7,) . (Add~') tJ~
/lJU iA~, fb/(} iMtI
7. TYPE OF w01:lK 'Fireplace 0 tic 0 De9K'o Re-roofing 0 Porch 0
New Construction 0 Alterations ~.~_ ....... l(~~n,,:: Fi9,iShAAttic ~ r /_Re-.sidin~ Finish Basement 0
ChimneyO Misc. ~d~ ~I'~
8. PROPERTY AREA OR ACRES . 9. PROPERTY DIMENSIONS C. 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
39/ -SJ/t/
SEATS
16. PROJECT COSTNALUE
If} ( I tflt1. (;/2)
17. COMPl.€TION 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
:uilding official can revoke:::7i fo i:st _ ? ~rmore, I hereby agree that the city o~~nnter upon the property to P~rf~i~4ons.
~ ature LicensEl'No. / !>ate '
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $_
Sewer Tap ................................... $
$
'1!i;]S'"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
1- 25'
Gas Fireplace Perm~ ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Mechanical Permit Fee ..................... lI".
Sewer & Water Permit ...................... $
This Application Becomes Your Building Permit When Approved.
By Date
Issued
Other.................................. ....... $
Total DueOV........................... $ I ~ .(:0
Paid -;(;,. -- Receipt No. '6'17/4
Date :J-lk-91 ByQJ(uJ
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceeJ'as requested. This document when
signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Certificate of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850