HomeMy WebLinkAboutBuilding Permit 99-0277
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDUL~ /~~;:Z-Cj' A.(-.-
ADDRESS ~J>;;'~ ~ ~
OWNER CONTR.
PHONE NO. PERMIT NO. Cjq -d.? 7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
iCFINAL
/ J SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXIGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL J{ ~
"ftrzrl ~ ~
(~--~')
...............
-
-
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WJRK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: t:J::t-.- Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
DAt~ RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
-.1&
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
4--~--Cf~
2. SITE ADDRESS
1.f9 2--4
p 0 ~.tJ
""'1/1'1
(/' ,<- -,
3. LEGAL DESCRIPTION
I
ADDITION (0r1 {.pH .tU~ t:)VlO~S
. (Name)
~AIJ6IetJ
LOT
BLOCK Z
PID 15 -{)Cf /- t:D& -()
4. OWNER,
",-Jll(f'
5. ARCHITECT
,~
6. BUILDER
tfB 1-Ltpro~ ~N
(Address)
(Tel. No.)
ct/- '-/ i.f7 5 tf- 7-3
(Tel. No.)
(Name)
(Name)
New Construction 0
J I~ ~ 7 .<Iel. No.)
-r.., .... '-r 0 '" r
gG30 IV 136~T 01Yll~c MN
Fireplace 0 Septic 0 Deck 0 Re-roofin~ Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 I ~inish Basement 0
(Address)
YnOJ..l~ 8 vI ~
7. TYPE OF WORK
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
1. White
2, Pink
3. Yellow
File
City
Applicant
Permit No. 0,7-777
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. PRJ}!"ECT COSTNALUE
~ ".s- c::>D .
17. COMPLETION DATE
4-B-;~
10
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 a m ntioned 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
bui' . I can revoke is p 't for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf~6d.insPTtiT'
sign~ ~ License No, Date .
----
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid Totn ~..................~~~~i~~~O~ .?4AtO
Date '-1-zrj1 By
~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
250Q.Od
USE OF BUILDING
f&.. '" .
/
/-} /Ir'
I
TYPE OF CONSTRUCTION: I II III IV C:f2
Occupancy Group A B E F --::I:;l I MarS U
Division 1 2& 4 I /
Permit Fee ................................... $ ) ''1'
Plan Check Fee ............................. $
City:
Ie;-
State Surcharge ............................. $
1.2c..(
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
GaS~irep. ~i .. ..~..... ......... $
This i 10 es .. Permit IJ'{h,en Approved.
By ~ .-40 Date '-{ '5.:.cr cr
V - / .
Certificate of Occupancy
Issued
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
o COPIES
PLOT PLAN
o
/&.d5'
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 constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
24 hour notice for all inspections 447-9850
Special Conditions if any
City Planner
Date