HomeMy WebLinkAboutBuilding Permit 99-0266
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS / 5 ~ ()9
OWNER
DATE TIME
SCHEDULED
10 -/9'-" A .f;
,
~~,
CONTR.
PERMIT NO. 91 -OJ 6 ~
PHONE NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~
cnF:. 2~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A FINAL
o SITE INSPECTI~
COMMENTS:
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ G~AIR TST
~~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
-.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
,~FORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
'2. SITE ADDRESS
/560<7 Cc,IJ/heJT
1. DATE
t.j~'}. -//
}J f"" ;t IS
PIDJe;- D'~ 5-aJl-o
v<--
3. LEGAL DESCRIPTION
LOT J.J. 1-
ADDITION jJm'--\ lI\
BLOCK
Gvr,lr (\ \}J()()d
Th,'r:J.e--t
(Tel. No.)
C.9/ I'f1 vr ~< J/f"" 'I '-/ (),;;., ,
(Tel. No.)
(Name)
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
Kt:l517<-
<:[t? r €" 4C67'1 7r mA
<:{6:f ,. )0;Z0
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing)Z" Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 97-2 ~ (p
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 locai laws and will proceed in accordance with submitted plans. I am aware that the
building offici an revo . 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 ~ '- ~(:)o;;;q S~O ,/-:2--97
$lg!lature Lioense No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING J n S A \ IZ
~- \
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2, ~o -c:;:)({'
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F ~ I M
Division 1 2 {;Y 4
Permit Fee ................................... $
~S U
City:
7 y. 7C;
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
J.2~
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
WaterMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Po. T 'fflJ' .......... ........-;,:;;,~;~: !!52
Date 4-2 -97 By f!b.-
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 ...................... $
'ng ermit ~)1en ApJ2!9ved.
Date <.(-2-'-1
Certificate of Occupancy
Issued
city Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850