HomeMy WebLinkAboutBuilding Permit #99-0327
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEQ /d -ZZ-c; '}
A.-7:
OWNER
(l~ ~ ~,
J
CONTR.
ADDRESS ~9 c:;
PHONE NO.
PERMIT NO.
9/-327
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
g; FINAL 0 PLUMBING FINAL 0 GASIJtoIE AIR TST
/D SITE INSPECTION 0 MECH FINAL )li /~
COMMENTS: ~ ~ ~ f
(~~~
'-- ,.- -. ,- -~
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.:::C< h ~LL FOR REINS:::,::FORE COVERING
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
1
i
J:1AIf RECEIVEQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
4-~z-/q~
Permit No.
qq-32-- 7
,
. 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
1. DATE
1../- I~_ ~7
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
5'~e; ~
C!.. 4Yl J- -J ~ o'L l' ,...
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
2- BLOCK PID 2.5 ~O q'Z.- - tJO 1- '-0
L A ICES ( 0 G fv1 f'r1\J c)Y2- 1111 e.. D
4. OWNER (Name) (Address)
l;::...(2e> "-I ~I"'" .
5. ARCHITECT (Name) (Address)
6. BUILDER (Name) (Address)
5Q:..r\c:l~ ~+ ~"iffs's J3D~"~ "' . 'Sf.
7. TYPE OF WORK Fireplace a Septic a Deck a
New Construction a Alterations a Addition a Finish Attic a
(Tel. No.)
LJ'-I"7-go"
(Tel. No.)
13. TYPE OF CONSTRUCT.J.QN
i2-E-S;: (Db
14. FLOOR AREA APPORTIONMENT USE
ADDITION
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
4Lt7-~OO J
Re-roofing a Porch a
Re-siding:l!( Finish Basement a
SEATS
16. PROJECT COSTNALUE
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
17. COMPLETION DATE
Yes No
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
rty 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
permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
7"%-S) LJ-'7--9~
x
Signature
License No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS a SETS
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z. ~ c:rU
SURVEY
PLOT PLAN
a COPIES
USE OF BUILDING
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ................. no... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
74.-;5
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty......... ......... ..................... $
Plumbing Permit Fee ....................... ~
1.25
Mechanical Permit Fee ..................... $
Pressure Reducer ..............,........... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Perm~ ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Water Tap ................................... $
Builder's Deposit ...... no............. ...... $
Other ......................................... $
Total Due.............................. $
Paid 7 (., . 0 0
Date +f,J q q
"ifa. 0 0
Receipt No. _~~ u U I
~
Certificate of Occupancy
Issued
By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina~ce and may proceed as re ested. 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 ~ any
24 hour notice for all inspections 447-9850