HomeMy WebLinkAboutBuilding Permit 99-0520
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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,
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA'IlO~., JIJ_ t:A)
,4FINAL ~ 'P-7 '{Y
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
n 11
~ L,;;;g
v
DATE TIME
IJ."~-"Iq
~
1'1-SO<.O
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/fY?\
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
f5
19, PROPERTY DIMENSIONS 1'0, CULVERT SIZE
Width Depth Yes No
e fumished infonnation 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
e and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thaI the
armit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
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DATE RECEIVED
5/tO/r1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
l'5no/ql
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SIjfE ADDRESS I I II
ILlto,{,., Hs~</, ttJ C
3. LEGAL DE~RI~'ON I
LOT ^ 4- BLOCK
pus.D
PID 2.5 - ZOS ~ o.J.3 - 0
ADDITION S.4ND pr :?N.D
~
4.t5NER crame) (Address) t!- I/vp
o A.. ~.y )~ "I~ l.. IY/<tL SP{~
5, ARCHITECT (Name) (Address)
(Tel. No.)
"4~ -0<./:23
(Tal. No,) I
I
6. BUILDER (Name) (Address) CDII..J'_~7'0el. No.) Il \
0' I -J I:>U""""'5<J~.
7~~~;) ~~h,~:oN\U;a:L ~)~~~~~~flV'.:jo
New Construction LJ Alterations LJ Addition 0 Finish Attic 0 Re-sidin~ Finish Basement LJ
Chimney LJ Misc.
8, PROPERTY AREA OR ACRES
Sq.Ft.
I hereby certify that I h
the abo e mentioned
buildin fficia can re
X \ ~
Signature
License No.
0.10
Amount Brought Forward .................. <t
Park Support Fee ........................... $
SAC .................................,....... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... It
Meter Horn .................... .... ........... $
Water Meter ................................. If"
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $:
Builder's Deposit ............................ $
Other ......................................... ~
Total Due ....,........................, $ -;1",. crD
Paid t<'. 00 Raceipt~o, .3S"/S/
Issued -I I. 1!:::::: '
Date S/lC/qct 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 proceed a 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.
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
USE OF BUILDING
'/;!'f?'.f HIlL
PERMIT VALUATION
'2 >,.f", ,~
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A
Division 1 2 3 4
S U
City:
Permit Fee ................................... $
7t..f.zr
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I.c...r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq ~ 520
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
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LJ
PILING LOGS LJ PERCOLATION TESTS 0
PLANS & SPECS LJ
SURVEY LJ
SETS
COPIES
PLOT PLAN
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