HomeMy WebLinkAboutBuilding Permit 99-0247
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
,
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ... . n ~ 0 SEWER HOOKUP
~ FINAL ~~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
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DATE TIME
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9 cr . d. '/1
,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/)tA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
;7:21,/ f f
PLt6
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Permit No. q Ct - d.-L{l
1. White
2. Pink
3. Yellow
File
City
Applicant
QATE RECEI\[EQ
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE AD,ESS e:J.-/,
~ () 91 ~\fldEE'L
3. LEGAL DESCRIPTION '\ ., __ 3J;:;-0 ( 1-0
LOT ~ ~LOCI't. a- , A, 1'~. J5
ADDITION 0aA~ lKt\.~ d~ ~
4. OWNER (Name) (Address)
\!11l16AtJ CAuL J t D 9 9 HLjEE~ f,1/.
(Name)
.l/f
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Tel. No.)
i/f?-g2J~,;L
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Address)
(Tel. No.)
6. BUILDER (Name) (Address)
S;;t.{ fl. -:rill ~ flu 1,'LAe DR,' }./,- 1
{:: J~KCA-O"- R_~O 60;;;oAi 1/ ~~{~1 A .,~";",o ~:,~ (,:2 7
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-sid~ Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 11 O. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 orm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building o~ cJjft revoke thi~ p~r jllst cause. Further ore, I hereby agree that the city official or a designee may enter upon the property to perform n~ed~'nsp . tions.
x~~//,(' ~f ~-:;;2..Dt'Y L/ /!9--9 c;2"7 -;3 /~~ '9'9
/ ) sjgnaylr-;' / / License No. / Da -'
/
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT;/s:r~!. ~
. \
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~ ~ A1 K
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
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 ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
ILf~/S-
I.~S
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... '1',
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Mechanical Permit Fee ..................... !I:
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $ Water Tap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $
By Date Other ......................................... $
Certificate of Occupancy Paid JOi~uff5"""""'" ~~~'~i~~ ~o$< -r: ~3P
,=", . 0..3131 1'1 By ~;kw
This is to certify that the request in the above application and accompanying documents is In accordance with the City Zoning Ordinance ~nd may proceed as requ~. 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.
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850