HomeMy WebLinkAboutBuilding Permit 99-0321
CITY OF PRIOR LAKE
INSPECTION NOTICE
S~~~EDULED
DATE TIME
/o-(S -9'( ..A-.YL
ADDRESS / S3t 5
~~
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
'lll. FINAL 0 PLUMBING FINAL
o SITE INSPECTION /J ~ MECH FINAL
COMMENTS: ~.
;(~~
-- --....
C€ ~;/~;!;>
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~
9t1~ ~ 2---/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~-
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOy. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . Owner/Contr:
- I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
APR J 2 919
. 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
IEIls" ~U'/-WN .5.##~
3. LEGAL DESCRIPTION
\
'"{)rlO V
arn
L
LOT
ADDITION
4. OWNE':lt (Name~
.If NTIMN " PonZE I'L
5. ARCHITECT (Name)
1. DATE
4-{2.Lf I
~U~D
PID d5 -ll1 --() (3--0
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
~ -3L/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Address) (Tel. No.)
/~ ~N ..5~~ 'Ilf7- .5~h
(Address) (Tel. No.)
13. TY})E OF ~ONSTRUCTlON
Kif- ~1JO F-
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
tL.~,- ~F?J~
7. TYPE OF WORK
(Address) bIAS I 553?:J -reI. No.)
laDO /LT# ~L 8't~'72/B
Re-roofing ~ Porch 0
Re-siding 0 Finish Basement 0
New Construction 0
Fireplace 0
Alterations 0
Deck 0
Finish Attic 0
Septic 0
Addition 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. PROJECT COSTNALUE
1boo -
17. COMPLETION DATE
nformation 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
th~ ~bove ~en~perty . at aU construction will conform to all existing state an~ local laws and ~i11 proceed in accordance with submitted plans. I am aware that the
:U1ldlng Offl~~k' rmlt for Just cau e. Furthermore, I hereby agree that the c'~;ZI3r ;Ze~nee may enter upon the property to perf03n~~ inspections.
~ ~ ~~ ~
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
r2~s A-irt
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
Plan Check Fee ............................. $
1l\.lS""
I -1':;-
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
FOR ADMINISTRATIVE USE
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
asro~oo
SURVEY 0
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Certificate of Occupancy Total Due .............................. $ 1L,-f)O
Paid /(0.00 Receipt No. '348 L-( 1
Issued
This is to certify that the request in the above application and accompanying documents is in accordance with the C~:~oni~~~n~~ may pr::ed as reS,,~~ ::! 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.
City Planner
Date
24 hour notice for all inspections 447-9850
Special Conditions ~ any