HomeMy WebLinkAboutBuilding Permit 99-0200
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
fJ-a.-qq
I
ADDRESS
S??? ~ ST N.P.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ,,4')
M FINAL I'IAnf([ \.lJ/
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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- - U
/,U.M- ~
V
~ zffi
CJ9-rXOO
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
l}( WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
,/fLIA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTI
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
1. White
2. Pink
3. Yellow
File
City
Applicant
.Z4.
Permit No. 7t - 200
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
(I t1r1fU" \.lJOnrl ~ IV rC
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
. "TE ADDRESS
5"lqq
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
3. LEGAL DESCRIPTION
&;
ADDITION 5a..v1..d
LOT
"':;OWNER
5. ARCHITECT
~QUILDER
rU.D
BLOCK
.pf)'1 vi te.
Z
5m Addn.
12. NO. OF STORIES
PID ~5-J?:/f -02lo-D
13. TYPE OF CONSTRUCTION
f\ (Name)
L:nf\f\\ f.--
(Name)
(Address)
A(\rl"'r~on '51Qq ('ldt1.J1,UO(),t
(Address)
(Tel. No.)
If D3-Q-flX"
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
'Scl fY\ e...
Fireplace 0
Alterations 0
SEATS
16. PROJECT COSTNALUE
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofingJ( Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
1 O. 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 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
buildingAticial can revoke ~s permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ('Jrlv.,.li. 1('Vvh~ 3-CJ4Jt9
'-'" v S~,_ License No. Dale,_
':,,'..'J;,"/"t..;
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILD !:(lG
~c:.
I
IJ. IR
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION -2... ')~o6. 0 0
.
o COPIES
o
SURVEY
PLOT PLAN
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7C. . (0r
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............. ................ $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
7 "I. 7'5"
1,2s
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid T~)Je ...................~~~~i~;~O~
Date .5-:2 4 By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinarice and 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.
~~....!l~~;I~i~~.~.e:it Whe~APP~'::~
By ~ Date ~ L,'. F\..
Certificate of Occupan(
Issued
7{p.t%/
~ ({ r~ ( I
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850