HomeMy WebLinkAboutBuilding Permit 99-0421
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS /.501 ,j, 7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION(B
~ FINAL
o SITE INSPEC
COMMENTS:
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W~
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DATE TIME
SCHEDULED
(0 -f'f -'I
()~ MIL
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A.I'
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CONTR.
PERMIT NO.
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~LL FOR REINSPECTION BEFORE COVERING
Inspector: W + ( Owner/Contr:
/
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
----.-.-----
am'RFr.FIVFn CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicanl
1. DATE
Permit No. qCf --4 2./
Chimney LI Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yas 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 property and thai 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 official ~J;k~ thjsJl~~it lor jus cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X r nPl<..P /1 J
Signature .......
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
4"'~-99
2. SITE ADDRESS /
/SJ..7
~r;-{ CU
St'
3. LEGAL DESCRIPTION
12..
O,l\lC..-
2-
t"T
I~
PID 2S-(')fI;3.-()3;7 - 6
ADDN.
~~7~o~d"?
(Tel. No.)
LOT
BLOCK
R,m(SG:.:
ADDITION
4. OWNER (Name)
#ant ~M.h
5. ARCHITECT - ame)
(Address)
~h..E..
(Address)
6. BUILDER
~
(Name)
(Address)
(Tel. No.)
W.;l.-
:31Y~
~
~Cf!~
Septic ~
Addition 0
3l;so W iO () 5jt
~ ~J1/
Deck LJ . Ae-roofing--=. Porch CJ
Finish Attic LJ Re-siding CJ Finish Basement CJ
7. TYPE OF WORK
New Construction CJ
Fireplace CJ
Alterations CJ
License No.
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEAT~
16. PROJECT COSTNALUE
17. COMPLETION DATE
Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... <t
Collective Street Fee ............. .... ...... ,It
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ,It
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7 to .0 (\
Paid "1~.0 0 Receipt No. 3<;;t)'7C;-
Issued 4f. ,..t1.tA _ .
This is to certify that the request in the above application and accompanying documents is in accmdance w;th the c~:;oning 6;:'~(~~aY P':':d J:;;,:S~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.
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z. S'lf() .
USE OF BUILDING
~e~
,
k/ t<?-
TYPE OF CONSlRUCTtON: I II III IV V
OccupancyGroup A B E F HIM R S U
City,
Division 1 2 3 4
Permit Fee ................................... $
1+' '7 ')
Plan Check Fee ................. ............ $
State Surcharge ............................. $
Penalty ....................................... $
\,2..S-
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your BuildJng Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA 0
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ
SURVEY 0
SETS
COPIES
PLOT PLAN
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