HomeMy WebLinkAboutBuilding Permit 99-0347
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
13-7-9 ~
ADDRESS
{</3( ~ 57
v
OWNER
CONTR.
PHONE NO.
PERMIT NO.
cr 7 -:?<i7
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 6'\ 0 WATER HOOKUP
o INSULA TIO~ ~ \!Y _ 0 SEWER HOOKUP
)( FINAL ,u ~I ". .~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
l
0/(
-
~ -/<-fP
~RK 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
R5
DATE RECEIVED
4-le~/q~
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.
qq-34-i
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
4/1 ~L~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. S'i:4&a
3. LEGAL DESCRIPTION
LOT .~ I BLOCK
~'rUnt~ ~
c-' (Address)
~e;... ;>,..t:.JJ,
(Address)
~~
I
~
12. NO. OF STORIES
PID S ~ - r ,4- - 0 13 - 0
13. TYPE OF CONSTRUCTION
ADDITION
~ (Name) ,
- ~ "--.oJ.;_ ~ '"
5. ARCHITECT (Name)
(Tel. No.)
~-4-S-~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~k~- d. ~~
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. ~
OCCUPANTS
Re-r~~ Porch 0
Re-Siding^ Finish Basement 0
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
._~ Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
ion 0 IS applicat!on which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
s ction ~comorm 10 all !!lri5Iicg state and local laws and will proceed in accordance with submitted plans. I am aware that the
e. u ermore, I hereby agree that the city official or a designee may enter upon the property to perto needed' s tions.
1
'---'" License No. Date
x
,
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
8ack Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION z.. ~ 00. au PLOT PLAN 0
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12.e-~ Ale
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Cify:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
'7c.f.iS-
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
MeChanical Permit Fee ..................... $
1.2r:>
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $
Certificate of Occupancy
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 1(0.0 0
Paid 7(, . 0 0 Receipt No. ?J'56 ( 4-
Issued iJ j "
Date 1- / /3 / q Cf. By O/J...t:A.. '
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 aPrequested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
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