HomeMy WebLinkAboutBuilding Permit 99-0208
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
/J-. J- r3
ADDRESS
:5SCJ7 ~ 51. S.F.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
icr- ~ (j <c>
o FOOTING
o FOUNDATION
o FRAMING
~SULATION~~
FINAL .IlP \tJ/
o TE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
J
011
/~M
~ORK SATISFACTORY, PROCEED
~'ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/lLA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSNOTl
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.2,.
1. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
Permit No.. UfJ -;A 0 ?'
. 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
.5:5<19 j;OlLlu-tU sf-
3. LEGAL DESCRIPTION / Y'
LOT ~ BLOCK .
ADDITION btnrsv; /11' fit liS ~'f~
~-AS -97'
~.f. t/
PID:l5 - /CC7- f'J,s-q--{)
4. OWNER
J[) A- Ai
5. ARCHITECT
(Name)
1?
(Name)
(Address)
(Tel. No.)
<1ft> -b3 37
(Tel. No.)
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
~a.L '<;
7. TYPE OF WORK
New Construction 0
!i3? () -f../ Y1 '1_ :L e.dA- Ai
Fireplace ciI Septic 0 Deck 0'
Alterations 0 Addition 0 Finish Attic 0
!fLu ftj,;-,J737
Re-roofing.8( Porch 0
Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
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
bUi~icial can revo~his 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 7/r.J'ra..u # J-.J)~ ~O/35'1<6 h ~ -d~-9q
Sigr1iirare License No. Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
j)
USE OF BUILDING ras
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
r+,/~
j
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
Plan Check Fee ............................. $
It.{ .15"
'(~S
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
S U
City:
State Surcharge............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7fo.ro Receipt No.
Date -3 JS -4Ct By Q f4.AJ
This is to certify that the request in the above application and accompanying documents is in accordance with the Cify 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.
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
(~ C()
3<-1y (~