HomeMy WebLinkAboutBuilding Permit #99-0310
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL~D
DATE TIME
/a -/P'Jj-<J ,(. T;
ADDRESS
/<//R/ (I~fl.~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
xrFINAL 0 PLUMBING FINAL
,/ a SITE INSPECTION 0 MECH FINAL
COMMENTS: ~
~;~
C(1/~
99 -t:2.?/o
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA~h'-N~IR TST
7'~ .
~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, 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
-~_._-_.__._----_.._-
QATE Rf;CEIVEQ CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
cqQ-31()
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
/4/'fr1 (~A,^/f)u? 1Uf'}-r) ),..,/IP
1. DATE
1/-Cj-Cjo,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
ADDITION
4. OWNER
----
.-J~f\
5. ARCHITECT
BLOCK
:POIN
4-
411o'l
12. NO. OF STORIES
LOT
2-
SAND
PID 1.5- 2..15-04& -0
ADDN.
13. TYPE OF CONSTRUCTION
(Name)
~ J €..l/\li\ ,C... "
(Name)
Lhnlf
(Address)
/41 k I
(Address)
(Tel. No.)
tA"A./Jlf(~y)J Ifi-..{l11:
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
?:rk-~
7. TYPE OF WORK ,,-) Fireplace 0
New Construction 0 Alterations 0
1-0 P.( ) M~Je:r
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roolin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
17. COMPLETION DATE
Yes No
I hereby certify that I h ished informa" tion on this ap~lica . ich is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentio pro and that all ru' will to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official n re e this pe~for ju ,ause. F , hereby agree that the city official or a designee may enter upon the property to pertormL n,eded inspections.
X . u. >- ), q-9-9C?
./ Signature . - License No. Date . r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
e..e: <;
AIR-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
25U1) . 0 (J
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
1t.+.75
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
MeChanical Permit Fee ..................... $
J.2..S-
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /~ .00
Paid ..::1Iiif!;;/ 7&.()lJ Receipt No. . 3~ee ~
~ ~. ~W
Date . f 'I By Jgl::1:) ~ _.
This is to certify that the request in the above application and accompanying documents IS In accordance With the City Zoning Ordin nee a d may proceed as r~ested. 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.
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850