HomeMy WebLinkAboutBuilding Permit 99-0328
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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OWNER
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ADDRESS I (P 1./1../7
CONTR.
PHONE NO.
o FOOTING
o FRAMING
I\. 0 INSULATION
~XFINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: !loop
'19 - ?2S
PERMIT NO.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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o EXC/GRAD/FILLlNG
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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
1. White
2. Pink
3. Yellow
File
City
Applicant
4/czf1 &'{
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN L/_ I~
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) ~.:r BUILDING INFORMATION
2. SITE ADDRESS Oc:.( l~TL t<.~ 11. SIZE OF STRUCTURE
I , c( q) A tJ /<:. .5 F': (Height) (Width) (Depth)
3. LEGA~ESCRIPTION 12. NO. OF STORIES
LOT e~f ~ BLOCK PID 25 -qOz... () 8'~ r
(l,U1I5 In btJU,nds 13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER .n~ame) ~ (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
)..eo or L/</?_ cye;:> ~
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
lee::> !l",J OCCUPANTS
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-rooling,iL Porch 0 SEATS
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq.Ft. Width Depth Yes No
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 above mentioned POd 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
building o~n revo this p rmi,jUst cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X JO --... </-/,;?... 91
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
Actual SOIL TESTS 0 ENERGY DATA 0
Front Back Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
e.~ kite- SPACES REO. PLANS & SPECS 0 SETS
USE OF BUILDING
I SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION Z-s, u-D. QL......- PLOT PLAN 0
TYPE OF CONSTRUCTION: I II III IV V Amount Brought FOlWard .................. $
Occupancy Group A B E F H I M R S U City:
Division 1 2 3 4 74-. 75 Park Support Fee ........................... $
Permit Fee ................................... $ SAC ......................................... $
Plan Check Fee ............................. $ Collective Street Fee ....................... $
1.2~ SewerTap ................................... $
State Surcharge............................. $ $
Penalty ....................................... $ Pressure Reducer .......................... $
Plumbing Permit Fee ....................... $ Meter Hom ................................... $
Mechanical Permit Fee ..................... $ Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $ Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $ WaterTap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $
By Date Other......................................... $
Total Due .............................. $ I~ .<' 0
Certificate of Occupancy -He.CO 35001-
Paid Receipt No.
Issued 4-/I?~q q ~JJOLe-
Date By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin/nce and may proceed a~~ue~. 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.
City Planner Date Special Conditions n any
Permit No.1j - 32 g
24 hour notice for all inspections 447-9850