HomeMy WebLinkAboutBuilding Permit 99-0516
DATE TIME
CITY OF PRIOR LAKE JO~Jf?
INSPECTION NOTICE SCHEDULEQ AJr:
ADDRESS ~ P~.G ~tY ....At' ,
OWNER CONTR.
PHONE NO. PERMIT NO. 9'1-51{,.
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL Jl ~
~d ...~.~ ~ ..J J '
/"'" ~,
(~/~ ~..J.)
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W01' CALL FOR REINSPECTION BEFORE COVERING
Inspector: 0- i Owner/Contr:
gALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
-- _._.~"..-_. ---_._..__.__._-_._~~-_._.._._-_._--_._-
~~
DATE RECEIVED
5/7/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Q?-5'"/tP
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
I ~?-1'7
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. ?'~ ADDRESS n /
'Ti'</~ ua...ILOh:<-
g'".::
c;h
3. LEGAL DESCRIPTI9N
LOT MII!r1'rf ~ &".wO..fBLOCK
PID Z5-00l- () (3 - ()
12. NOj ~RIES
13ffPE OfY'ONSTRUCTION
1\ CK) ,h<:-~_ -
~ 14. FLOOR AREA ApPORTIONMENT USE
~No'~ IW
ADDITION
4. O~ J4-. (Name) ./
"'V'ON m~t7rde"
5. ARCHITECT
(Name)
(Address)
~~
(Address)
(Tel. No.)
&/cd..4.... .5'" S' E-
(Tet. No.)
6. BUILDER (Name)
(Address)
(Tel. No.)
15. NUMBER OF OCC~NTS OR SEATS
OCCUPANTS ~ _
SEATS
16. PROJECT COSTNALUE
s fl1"'e
7. TYPE OF WORK
New Construction a
Fireplace LI
Alterations LI
SepticLl
Addition LI
DeckLl
Finish Attic CI
Re-roofi~ Porch LI
Re-siding rr' Jlinish Basement a
......:M vn~RES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
j Width Depth Yes No
I h eb ,certify that I have)(Jmished 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 entioned peny and. that all.construction;1l confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
b ding officia vok t i pe. cause. ;u(, eooore. I hereby agree thet the city oo;cial or a designee may enter upon the propeny to \fi'7"~7.."y~
S a e _ ,. LICense No. Date ~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
CI ENERGY DATA
o
L6 K/AL
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS LI PERCOLATION TESTS LI
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS CI
SURVEY a
SETS
COPIES
z n/7) _ tflJ
PLOT PLAN
o
TYPE OF CONSTRUCTION: 1 II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .......... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
74. "1r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty................................... .... $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee .................. ... $
I. 'Z- r--
Sewer & Water Permit ...................... C:
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Gas Fireplace Pennit ....................... $
This _n.Beco.(.s y~..,Q;ng P....oott Wh~n pro/!ll!.e1
BY/C ~ . .p-~;te .$ '7/"t 1
7 ' ,
Certificate of OccJpancy
Water Tap ................................... $
Builder's Deposit ............................ $
other ......................................... $
Total Due .............................. $ "Ff6. c/D
Paid 7(, . VV Receip1 No. S ~ IS" (.
Issued
Date ..rf /('1 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr~ reqU~sted. 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
Dale
Special Conditions if any
24 hour notice for aU inspections 447-9850