HomeMy WebLinkAboutBuilding Permit 99-0254
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
9-d1-1~ A:T:
ADDRESS
6~31
tJC7~.o~N
OWNER
CONTR.
PERMIT NO.
q9-~s;'f
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION e
FINAL
~ SITE INSPECTI
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 GAS LINE AIR TST
o
COMMENTS:
4.
/
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspector:
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
-
llll
2. SITE ADDR~ L/ 3 I
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
:O~~TION
ADDITION ~s7de.
4. OWNER /< (Name)
\I? (,c. i1
5. ARCHITECT (Name)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 91 - 251
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(TeL No.) 14. FLOOR AREA APPORTIONMENT USE
'11./ J- 3Q;
6. BUILDER; (Name) ,
,zUr&-tlO~
~ 7Jr- (Addrestr3lf5
/) /:.,j (Tel.~o.) __
t,../A~..,.. ~r ..Fe:.";
~'l( /7. 2. qpo
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing tll----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
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJ
r---'
;7
I hereby certify that I have fumished i formati 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
nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
, I D~ 201~{n~C-
License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
x
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
00
USE OF B~DING ~
S. IJ ~
/
2.
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2(J> 4
Permit Fee ................................... $
S U
City:
'<t.1S-
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty....................................... $
1.2~
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o
COPIES
o
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid ~ ...................~~~~i~;~O$ ?~;ltzp
Date tf (-9)
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 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.
Sewer & Water Permit ...................... $
Thi
By
our Building Permit wyen Approv1cr
Date -l-
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850
By