HomeMy WebLinkAboutBuilding Permit 99-0454 re-roof
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL,ED
DATE TIME
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A.y::'.
ADDRESS
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/5.,).~/ ~;:J~~,
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
fJ~INSULATION r?:'l 0 SEWER HOOKUP
\lIl FINAL 'Il!J7 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: II 4tr1'
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H.A,~ ~
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
_/
-
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~
LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ 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 & SAFETYl
INSNOTl
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DATE RECEIVED
4-/~hq
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicant
I ::>IRECTlONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No.
_qq~4~L
~
1. DATE
It-d.-'(; -q L _ BUILDING INFORMATION
I 11. SIZE OF STRUCTURE
~\SD (Height) (Width) (Depth)
12. NO. OF STORIES
2. SI,TE ADDRESS
c:s ~u. \
3. LEGAL DESCRIPTION
l \
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I
LA
PID .z...~-Ic..~-t'?l\-O
LOT
_ BLOCK
S~6.e.,
13. TYPE OF CONSTRUCTION
ADDITION
4.~. (N~~ L (Address) . ~.Nti4cc)-
--:JI.:""~~ "-''- \S~\.1\ ~\<:..~ ~, _~;:}.\'S
5. ARCHITECT (Name) (Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address) '"\)\J;:o'(n\ ~~NO.)
\~()E. '\C\~,;\ 1\,,)--OOlt~
15. NUMBER OF O\..A..ut'ANTS OR SEATS
~\.q~-~~Il\)q
7. TYPE OF WORK . Fireplace CJ
OCCUPANTS
New Construction 0
Alterations CJ
Septic 0
Addition CJ
Deck 0
Finish Attic 0
Re-roofjn~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
Chimney 0 Misc..
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. FI. Width Depth Yes No
I hereby certify that I have fUrnished information on this application which is to the besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
above mentioned property and that all construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
u' ing offici~can revo~is'e_l['lit ff\i"t~. Furthermore, I hereby agree Ih'1t the cily official or a designee may enter upon the property to perform needed inspections.
0tl~\~~X~ . Cll'?C\~C\ . LI,_::-'I?_<;Q
Signature License No. . Date
1~O~ECT COSTN6':YE
"0 --
'. . ~--- --
17. COMPLE IIUN UAll::
---
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12.6'T
KlL...
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
L.. <01) _ cru
PLOT PLAN
o
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee .................. ......... .... .... $
-, 4--- , I c;-
Plan Check Fee ............................. $
State Surcharge ............................. $
'.u"-
Penalty ....................................... ,4::
Pressure Reducer .......................... $
Meter Horn ... .... .... ................. ....... $
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7". 0 (; ReCei~j :::;. 3 s<> if OJ
Date 4/ -z-'Ii /9(1 By ~
This is to certify that the request in the above application and accompanying documents Is in accordance with the City Zoning" Ordina~e and may proceed,d"s 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 01 Occupancy must be issued.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... ,4::
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By _ Date
Certificate of Occupancy
-UL .()o
Issued
City-Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850