HomeMy WebLinkAboutBuilding Permit 99-0489
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
Id--^ 7~W
TIME
ADDRESS
/00{ r,;~ ~ AlE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
? '1- tI'g 'l
o FOOTING 0 PLUMBING RI
o FOUNDA nON 0 MECH RI
o FRAMING tjj) 0 WATER HOOKUP
~~NSULATIO~.J - , 0 SEWER HOOKUP
)"""INAL AD """I ~~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
f))t
/&J;.fJ6
\ ~RK SATISFACTORY, PROCEED
~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
/f"fJ' Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicant
1. DATE
Permit NO.!iS - <1-6 0;
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yas No
rmalion on this application which is to the besI of my knowledge true and correct. I also certify that I am the owner or authorized agent for
all construction will conform to all existing slate and locallaw$ and will proceed in accordance with submitted plans. I am aware that the
for just cause. FU~hermore, I hereby agree that the city official or a designee may enter upon the property to perform "~~.J~ions.
. ~~~
. License No. I oflte' /
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
tF..:r7t
PVD
2, SITE ADDRESS /J J A , I
1~L>t, (blt91Z 1A,~J.:::d/'M
3. d;:G L DESCRIPTION
LOT I BLOCK 2-
S/fNO PI 3.eo
4, OWNE~ / pamo/) / .
~--::r/JTI aw1r1.tl5C'.Y\
5, ARCHITECT (Name)
}tlE
I
I
I
(T~3 -oLBt"J.
I
.1
PID 2S-z,/cf- tJr7-0
ADDITION
(Address)
~~,~
(Address)
(Tel. No.)
6. SUILDER
(Name)
(Address)
(Tel. No.)
~/~
/'
Ae-roofing IV': Porch 0
Re-siding ~njSh Basement 0
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
x
Signature
BUILDING INFORMATION
11. 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
OCCUPANTS
SEATS
16, PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .........."'............'........"'.... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... it
Meter Horn... .... .... ................. ....... <t:
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... ot
Builder's Deposit ............................ $-
Other ......................................... ot
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
,.:r.rTV .....-.--
USE OF BUILDING
J2er o/~
TYPE OF CONSTFlUcnoN: I II HI IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
PelTTlit Fee ...................... ......... .... $
S U
7c./. f)-
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $-
Mechanical PelTTlit Fee ..................... $
(. 'Z- r
Sewer & Water Permit ...................... $
~~:~T~....O~i~~i:.;it?1?fftf
1'1 '
Certificate of Occupa
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS [j PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
70.01:)
Paid Ie, ,00 Receipt No. 35'17("
Date 5/,/1Q By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning# Ordf'nanc~ and may proceed at requested. This document Whe~
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.
Issued
Total Due .............................. ot
CilyPlanner
Date
24 hour notice for all inspections 447.9850
Special Condrtions if any