HomeMy WebLinkAboutBuilding Permit 99-0272
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULE.P
ADDRESS
32Z~
... / >>4-.("'~~
,
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
pr FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~6trJ i><J
DATE TIME
1()~2z.-7' A:t,
/~.
11-C:<7~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
;:cr ~
COMMENTS:
~
,,,--,, II~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK?LL FOR REINSPECTlON BEFORE COVERING
Inspector: ro . Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
"" f-
Permit No. c('1 -2 ? 2-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SM. ADDRESS
~.1-1. ??
1. DATE
1/5- C)q
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTioN'
J~+
SurJt;et
~/Y1t!ct7 lA/. jJJ1/~/2J ~#Re-
BLOCK 4
;-Ir/IS I1dell I
)'--/"71 'J ()
PID':"";' '") - / d ~,o( -
12. NO. OF STORIES
LOT
13. TYPE OF CONSTRUCTION
ADDITION
4.oymER a (Name) i.
J it:) fi t L<)~'f ~ k
5. ARCHITECT (Nam .
(Address)
3.11.1 )hr/I/,/ /N.
~dreSS)
1/;7~NOp1:; C/
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7) tl hi /11(;([ ~/)1'tJ
7. TYPE OF WORK . Fireplace (j Septic
New Construction 0 Alterations 0 Addition 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
( 'J! /;/2/-~/?c,
Re-roofing ~ Porch 0
Re-siding 0 - Finish Basement 0
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
Yes No
SEATS
16. PRO~CT COSTN.A.l,.lJE
16 -1dY If. Of)
17. COMPLETION DATE
Width Depth
I hereby certify that I have furnished 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 abo ntioned properly 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
bull' flic' I can revoke t~for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the properly to perform needed inspections.
X I'" - ~s"Jn'!u,,;;: .{ d /?/) C? '1 ~ .9 -Cnse No. ~ Df 9
Front
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 2,SlX?Q(j PLOT PLAN 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILD~
fCes.
AIR
.,
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 ................................... $
7<.!.'2S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
1,'1.<)
74.7')'
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $
Sewer & Water Permit ...................... $
Po". .:.~l.:::;;~.w"o~
Date q, c....;.t7,
--V .." '/
Ce ificate of Occupancy
Issued
Paid
Date 4" 5- 71
Receipt No.
JC185" ( /)
By
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 const~utes 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 ff any
24 hour notice for all inspections 447-9850