HomeMy WebLinkAboutBuilding Permit 99-0214
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULiiD ItJ-U-?9 /A.~
ADDRESS
535iJ
~ ~ I?J2r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1'9-2/<(
COMMENTS:
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA~':}IR TST
JE~
~ Vo ..~ - ~
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
\iI' FINAL
/6 SITE INSPECTION
,/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.:~::ECT ~ ~LL FOR REINS::::::FORE COVEmNG
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
QATE RI=CEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1125.
- DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
3D7jc( / c:; q
K/
2. SITE ADDRESS ~
~ 3"30 (j ,,1c/~ r h :u~tl
3. LEGAL DESCRIPTION
I~) ~ d
LOT BLOCK PID .!J) -q (J / - 0 I d- -()
ADDITION j / / Lf d-;J - L!:J- If) (.' Y /93' Ll1. .51 u l/L/.'
4. OWNE~ (Nam1:l'~ /'.'
,11m. ~-'
5. ARCHIT~ (Name) I I
<) J.) fl) e:-
6. BUILDER (Name)
(Address)
(Tel. No.)
'-f<./7 ~,? ~ c;
(Tel. No.)
I (
(Address)
(Address)
(Tel. No.)
SIJP?~
I (
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Fireplace 0
Alterations 0
Septic 0 Deck 0
Addition 0 Finish Attic 0
Re-roofing~ Porch 0
Re-siding 0 Finish Basement 0
.---
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
Sq. Fl.
Width
Depth
Yes
No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qt{ -J-'4
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
I 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 ~:iu:;;XZ~: PCi: f~r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfo~7j ~si)o~
JSignature\ License No. Date f
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
8ack
Side
Side
BUILDING DEPARTMENT VALUATION
/J
USE OF BUILDING r(~ s ft J R.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I /I III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
Permit Fee ................................... $
7'-/,7S""
I .:J.~
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ...................................:l:
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid T~~(;2)""..............~~~~i~:~0~ ,J~~ rJ
Date ")'J S- '1''1 By ~ ~U }
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'" This docu~ent when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certnicate of Occupancy must be issued.
City:
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permn ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
$