HomeMy WebLinkAboutRoofing 99-387
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCH~DULED
ADDRESS
i~ 1);" t.j ~ r;~ rA
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION rJi)
]it. FINAL AI AN<l..-l\lJ/
o SITE INSPECTio~ ,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
Dj'
~ LcI(
V .
DATE TIME
J.,{- J -1r.r
J
'19- 321
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY, PROCEED
~~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/!fII\
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTJ
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
~'99ll
. 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-/7
~sD
2,SITEADDRESS ~5;2. '-/ &~
3, LEGAL DESCRIPTION 1
~ LI BLOCK ~5
~ (1]1H;J g.qr~L
4, OWNER Rob.(~fNamir ~l kf-!.~1 .
5, ARCHITECT (NamB)
(' ~V.(
Ir
PID r/~--{J-:;J7 ~ () jg-{)
LOT
ADDITION
(Address)
(Tel. No.)
(Tel, No,)
RIGHlg'W <fdRtJOFING
1200 E, 7~s$treet
~6HTfVAV( Bloomington, MN 55425
7, TYPE OF WORK Fireplace b€ 1 r; ~~~~ift:!! C Gec1 ~
New Construction 0 Alterations 0-" 4" Addit'9J! 0 ./J ,F~n1iAttic 0
ChimnBY 0 Misc, The... ~ (!yf-fJ V-,v...q, ~
8, PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
Sq. Ft. Width Depth
6. BUILDER
(NamB)
(Tel. No,)
./"
Fa-roofing r- Porch 0
Re-siding 0 Finish BasBment 0
10, CULVERT SIZE
Yes
No
-#
/1~'1
I. White
2. Pink
3, Yellow
File
City
Applicant
Permit No.
QQ,3g7
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (DBpth)
12, NO, OF STORIES
13, TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
l~ROJECT COSTNALUE
.r ?'17~O(;
17. COMPLETION DATE
v umished 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
p perty and that all Ion will conform to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the
OkB t~it .. - urtne ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections,
--J 1'./ /:. (!)vcJ 3 "l?7 Y -/ ?
/ - ~ License No, Date
x
~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
I"
1e..6"S ~ / rc-
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
Z-- ~ .- ~ PLOT PLAN
Amount Brought Forward .................. $
Park Support Fee ........................... ~ __,___
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ I~. ()V
Paid Receipt Nq. 's rt> '""' ~
Date 4(tq )'1-' By ~K-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning O~dinance 'and may proceed asAquested. This document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy, a Certnicate of Occupancy must be issued,
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
City:
ly..IS-
Plan ChBCk Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit FBe ....................... $
Mechanical Permit Fee ..................... $
l. & c:;--
Sewer & WatBr Permit ...................... $
Gas FirBplacB Permit ....................... $
This Application Becomes Your Building Permit When Approved,
By _ Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
o