HomeMy WebLinkAboutBuilding Permit 99-0433
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PERMIT NO.
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PHONE NO.
o FOOTING
o FRAMING
... 0 INSULA TlOfj... I
1 ~ )(FINAL Kc.A)-t"
o FOUNDATION
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAO/FILLING
o LKSHORE~TLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
(oo~ OIl(.
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR 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/
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 4-2-- 7-t:t i BUILDING INFORMATION
2.S~O~~ M/oR "'-"IN 11. SIZE OF STRUCTURE
~ ~ 's'.E. LnKT (Height) (Width) (Depth)
3. LEGAL DESCRIPTION 12. NO. OF STORIES
LOT 4 BLOCK 3 PID ?~ -I P>3- (')2..1-0
L-A~E:SI DE S5T1\TE:6 13. TYPE OF CONSTRUCTION
ADDITION
4. ()WNER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
B~~d,"," ~tU~ 'kxoS- a.~ Sr 5€ /.12- "Ho 5""'3 I
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
AD Od> v~ 8cr€l<1ollS ~ ( 5~,oIK.I-I-IL.L"> i- Il. - 3"''' OCCUPANTS
v.> ' <;7' f't:/<Jl.. l.<1.N !:)~ / 1:3 2.l.f\ I
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing SI... Porch 0 SEATS
New Construction 0 Alterations LJ Addition LJ Finish Attic 0 Re-siding 0 Finish Basement LJ 16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES I~' PROPERTY DIMENSIONS 10. 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 n"oned property a~En will conform to all existing state and local laws and will proceed In accordance wUh submnted plans. I am aware that the
ilding officia7~voke tDi$ ~ermit f u use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
X ./ . .....CZ ..... ~. / -:'0 .. P -,:ilOOq 817/ 9 .' '7- 27-9Cj.
........ .... G/ v51~i'fa"'re ~ - License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
Actual SOIL TESTS 0 ENERGY DATA 0
Front Baok Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
Q.~S p{/fL- SPACES REO. PLANS & SPECS 0 SETS
USE OF BUILDING SURVEY 0 COPIES
SPACES ON PLAN
PERMIT V ALUA TION 2'!)Vl) . crv PLOT PLAN 0
TYPE OF CONSTRUCTION: I II III IV V Amount Brought Forward .................. $
Occupancy Group A B E F H r M R S U City:
Division 1 2 3 4 1+,7~ Park Support Fee ........................... $
Permit Fee ................................... $ SAC ......................................... $
Plan Check Fee ............................. $ Collective Street Fee ....................... $
\."2..' Sewer Tap ................................... $
State Surcharge ............................. $ $
Penalty ....................................... $ Pressure Reducer .......................... $
Plumbing Permit Fee ....................... $ Meter Horn ... .... .... ................. ....... $
Mechanical Permit Fee ..................... $ Water Meier ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $ WaterTowerFee ........................... $
Gas Fireplace Permit ....................... $ Water Tap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $
By Date Other ......................................... $
Total Due .............................. $ -{(,..Oo
Certificate of Occupancy 1(, .cJl.; ~sca4-
Paid Receipt No.
Issued
Date 4-12-7 qq By IIfJIA
This is 10 certify that the request in the above application and accompanying documents is in accordance with the City Zonin~ ~rdina~ce aid may proceed Us requested. 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 0." Special Conditions if any
&~~
4l~~7~1
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. ~ - 4-33
24 hour notice for all inspections 447-9850