HomeMy WebLinkAboutBldg (Fire Sprinkler) 02-0932
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
6:/J,<Jf.;
ADDRESS
/ltfl3/1 DUvu /If fiVe, S. c--
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~t-os6
Dfl ~ /7)
2 , ~3 Z.
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o fli'VC
Sf?/Z4,.Jfc.
7716 1-106"
j /V /1 eT/VI TV
I
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL 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 & SAFETY!
lNSNOTl
i I
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Fl L-E
wi
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
.2. SITE ADDRESS
\ lP~ \ \.. \)~ L.-V~ AvG, S .S,
3, LEGAL DESCRIPTION
LOT
ADDITION
4. OWNER
('~/\..<...,^
5. ARCHITECT
BLOCK
PID
14. FLOOR AREA APPORTIONMENT USE
(Address) (Tel. No.)
\\~,.)\ \ .(")v'---'-'TlA-~' ~C,
(Address) (Tel. No.)
(Tel. No{ :>:>t ,~t ~
(&?!>I) S-SS -3'3c<..
Reroofing 0 Porch 0
Finish Basement 0
,
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 above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building cial can r vok this.~~use, F~"ermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X . rt..({ l t-'fX)O)" '-l~-0'--.
SIgnature . Ucense No. Date
(Name)
Of:- :)\',
(Name)
("-- . <-I;\- Po'O--
6. BUILDER (Name) (Address)
\l \\L\N~ Av70 l"'-""'c....- >p....., '" '-~ <...i>. \30\ I.-c,~It::A.-\ )T-
7. TYPE OF WORK Fireplace 0 Septic 0 Heallf1g'D """f51trmtJ\ii{tD
New Construction ~ Alterations 0 Addition ~ Finish Attic 0 Residing 0
ChimneYD Mise, ~\a...lf: .sA"\...\..N\~ ~:.;.{~~
8, PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
Sq. Ft. Width Depth
e~.
7 I ~', 6C-r. White
2, Pink
File
City
Applicant
3. Yellow
Permit No.
oz--- OQ32-
1. DATE
l'- \ D - O'L BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
z-\.. 0..01.,.. 01 if, 6
13. TYPE OF CONSTRUCTION
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
17, COMPLETION DATE
10. CULVERT SIZE
Yes
No
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Front
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
Side
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION (PO I 000. c:> c::>
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
$. A Check if 0 Sewer & Water Connection Fee ........... $
~"~:~~..::::~~;:~~oc ~~; W"'T_Foo .....................,
ctJ~' 1:&> p,Jd /lC;:ii;cr~;;;;~i~~"'7-
Issued t v All ' -'
I q' i-I/ Date .r~ ~tJZ- By .
This is to certify that the request in the above application and accompanying documents is in accordance wtth the City Zoning Ordinance and may procee<YasAauested, This document when
signed By the City Planner constttutes a temporary Cert~icale of Zoning compliance and allows construction to commence. Before occupancy, a Certific~~ ckcupancy must be issued.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
. Division 1 2 3 4 << _ . ~
Permit Fee ................................... $ ~{\Of.
Plan Checking Fee ......................... $
State Surcharge ............................. $~
Penalty ....................................... $
Septic System ....................... ........ $
713.1S
l.{.(,'S . Cz \{
3cJ .~-O
City Planner
Date
24 Hour notice for all inspections 447-42309:00 a,m. . 10:00 a.m.
Special Conditions ~ any
PLOT PLAN
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ...... ................... $
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $