HomeMy WebLinkAboutBuilding Permit 98-0608
2./3.09
I
1.5/50 F(7/~ / AWN 5I-1o~<;
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
C FOOTING
. C FOUNDATION
C FRAMING
C INSULATION
C FINAL
o SITE INSPECTION
C PLUMBING RI
C MECH RI
o WATER HOOKUP
o SEWERHOOKUP
o PLUMBING FINAL
C MECH FINAL
COMMENTS:
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DIJH I()
DATE nilE
tJ71, 008
,
C EXlGRAD/fIWNG
C COMPLAiNt
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
C
77--16 PI u6
j /V /1 e,;r/v I TV
I.
. C WORK SATISFACTORY. PROCEED
C CORRECT ACTION AND PROCEED
o CORRECT WORX,ZO:OR REINSPEC110N BEFORE COVERING
Inspector: eaJ:/ Owner/Contr:
/7
CALL 447-911'50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
III#IOTI
CODE REQU]PJi'~"ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
Q.ATF RFQ.EIVFD
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
q J,-,.J ~
~/jr
2. SITE ADDRESS
15't.S0 'tA.)rt,.. tvh~Vl <-"5lio~<
3. LEGAL DESCRIPTION
LOT .J ,"OCK ,j
4A.DOODWITINER--ON -:Jl4,(:E'e"l)': -*~-
~.. .-JAddreSS) (Tel. No.)
~y . Fl-'\.. /. ~/.5{) J4j;1L~'f~&hr.; ?:?-b..:f778
5. ARCHITECT · (Na e) (Address) (Tel. No.)
I....".~ SS
. ~.....~
PID ;r- /~ r- - 036- D
(Tel. '/?{,-5778
---r f(.o~ H-e'Pt'JCZ-~ IS/SO frl-'k L4:#IHI .5l-J;,~ teL
7. TYPE OF WORK - 'Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
Ne~ Construction 0 p flterajo~ ~ition 0 FpSh Attic 9 lijRe-;;jding. 0 Finish Basement 0
ChlmneyO MISC.~~....J.kA~ /kH../Ld M~
8. PROPERTY AREA O~ACRES I;; PROP~TY D~M'ENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
6. BUILDER
(Name)
(Address)
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
?.f-J~ f
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Oeplh)
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
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 official can revok~r just cause. FU.rt. hermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
X ~ r~~_ H-ISh ~<a.OJ.. - 051- b~9, q )."
,- ~ / , Signature _';~.~_,__._ License No. Date '()
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Side
Front
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
~~_'1~ it / ~
,
PERMIT VALUATION
,) rei. O~
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee................................... $
V
R S U
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
PLOT PLAN
o
7/"{)V
74tr
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit............................ $
Other ......................................... $
Total Due.............................. $ 16.~J/ ~
Paid 1/'./) (j Receipt NoJ3/ If
Date 1/f/11 By 1/1/tf
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
i.iS
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
$
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 as 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.
24 hour notice for all inspections 447-9850
Special Conditions ~ any
qf-~ 01
City Planner
Date