HomeMy WebLinkAboutBuilding Permit 99-0190
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
SCHEDULED
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DATE TIME
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
99-/90
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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COMMENTS:
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ' M.. r Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
~ DATE RECEIVED
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
qq-I LIO
Permit No.
. 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 f)....... _, . J r'I}' -r7 J
~ZO() l J:W!C KIvU Kc;j .5G
3. LEGAL DESCRIPTION
LOT I BH~<:K /
ADDITION ~\'OO 10)\1; 1ft:. Hi tis ~ 1i~ Metn'
~NER I(~ame) ,\ . (Addre~s!J. Lv' .
\. JQ,.\.J.e., H~TD(\ t;2C1:-) c..,(~~(
5. ARCHITECT (Name) (Address)
1. DATE
i-2C)-Q9
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
It/
12. NO. OF STORIES
cJ5:- dieD -('J6/-{)
PID
1~! OF CONSTRUCTION
~ - '( r;;L:F
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.) :2 '2..10 _
5Olo3
(Tel. No.)
&J
6. BUILDER (Name) (Address) (Tel. No.) ~ q 0 _
rbfl1.ofl EXtyiors '333 \a.rC l~tr-; tAt ~ vrl. 3900
7. TYPE OF WORK Fireplace Ll Septic Ll Deck Ll Re-roofin~ Porch Ll
New Construction Ll Alterations Ll Addition Ll Finish Attic Ll Re-siding 0 Finish Basement 0
Chimney Ll Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
. ing off' ial can revo e l1e it for' st cause. Furthe ore, I hereby agree th~~}iaa 7q~ay enter upon the property to p::Jr~:Je9n~~
License No. Date
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. 700ZC9:ND~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS
Ll ENERGY DATA
Ll
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING r2tc) ff1 ,~-
PILING LOGS Ll
PLANS & SPECS Ll
SURVEY Ll
PERCOLATION TESTS Ll
SETS
COPIES
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLOT PLAN
Ll
TYPE OF CONSTRUcnoN: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Pennit Fee ................................... $
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 ................................... $
Builder's Deposit ............................ $
Other ......................................... $
City:
S U
fL/- 7~
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Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennlt ...................... $
Gas Fireplace Pennlt ....................... $
This Application Becomes Your Building Pennit When Approved.
By Date
Total Due .............................. $ /~ < C()
Paid7? c 00 Receipt No. 3 (1~{'O
Date 3- 2z -QCi By (JJ!L-< )
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 as requ~sted. 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
Issued
City Planner
Date
Special Conditions W any
24 hour notice for all inspections 447-9850