HomeMy WebLinkAboutBuilding Permit 99-0206
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDl1LED
/J,3.q~
ADDRESS
SS3S
~ Sr.
CONTR.
OWNER
PHONE NO.
PERMIT NO.
crCf-Jot
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION .--..Jt1;)
)l FINAL oN -^"'"\) , \l1/
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 GASLINE AIR TST
o
COMMENTS:
OK
-
<~~
v
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/JL6{
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
);lATE RE~
~ l- ~~ S99
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
1. DATE
.a-~S-9?
BOtLAJ-t",
/
,e)
PI0c2S-- /87- () C)t!-()
<-t
. 4 ~
1/;'/15 ~--/'C4
$~~ So
3. LEGAL DESCRIPTION
LOT ~ BLOCK
ADDITION DWXJ!:23V//Ie.
4. OWNER (Name)
A&vll-L
5. ARCHITECT (Name)
(Address)
'+P :()IL
(Address)
(Tel. No.)
~slt? -'/755
(Tel. No.)
Ld~ J!- f . f/?/I/
,
6. BUILDER
(Name)
(Address)
(Tel. No.)
ilLLL ~
7. TYPE OF WORK
New Construction 0
mtV ~9;'-;7i 1
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
!?o ()-{. i t1 q
Fireplac#o
Alterations 0
.Io12d"'A/ '
Septic 0 Deck 0
Addition 0 Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qtj -dD(o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
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
:uilding 'cial can rev~it for just cause. Furthermore, I hereby agr:d j ~ff~i~~ ~eS;2e may enter upon the property to pe~rm ~~S ~sge9ons.
Signature License No. Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
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 ......................................... $
Total Due .............................. $ (~ cO 0
Paid 7ft;. 00 Receipt No. Olt55 (")
Date 3 -;1 S' ~ ~ By O.lLLJ
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 reqUest~d. 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.
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
11
fas tltl ~_
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
,4, lc;
Permit Fee ................................... $
I. 'l~
City:
Division 1 2 3 4
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o