HomeMy WebLinkAboutBuilding Permit 99-0536
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULEL>. /"-'l-OZ-'n A-v:
--:I~ ~.y - 4,
ADDRESS /~
OWNER CONTR.
PHONE NO. PERMIT NO. '71 - 53'
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)1 FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~ ~
--- ----' '
r 'f'7f~
\....
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
~,e.,...,
~ I
..........
~p
.--'
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~, 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 & SAFETYI
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
Permit No.
QQ-S30
. 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
L\ 1..>(0 L\ -rQlJJQ ~,
15:A~ _ CJ9
Je.-Z-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
{Height} (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
ADDITION
BLOCK
77Jwr=;}?JtJ6 WOODS
PID 25-23(- 007-0
5. ARCHITECT
(Name)
(Address)
L..\.(.,I.!j.. -rD\J..Je.AL <:;--r
(Address)
(Tel. No.)
QO\(~3Y'-lD
(Tal. No.)
13. TYPE OF pDNSTRUCTION
~Oot-~ <;..
14. FLOOR AREA APPmSrlONMENT USE
4. OWNER (Name)
-' ~\f}-"i'Oc.4\'
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
[)J Q.-c;.~
7. TYPE OF WORK
New Construction 0
'(')~/:' 10\' f\~ I~Cr CtJI~""1-63()L(
. . ''A \
Fireplace 0 U Septic a Deck 0 U Re-rootin~ Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0/ Finish Basement 0
OCCUPANTS
SEATS
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 190 PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 thaI all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUildjn9 Off" ial can revoke ~hi~ permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X (' (Y\ ~- ~(JI CCC:lPL, S-13-"1 q
=' Signature License No. Date
16. PROJECT COSTNALUE
{) I ~Ol{.
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
J!e> h/,JI:....
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
.)STV. n)
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
Division 1 2 3 4 7 t./ .1,r
Permit Fee ................................... $
Plan Check Fee ............................. $
City,
Amount Brought Forward .................. (::
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... ~
$
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
1.2.-)
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1ft;. 0 0 Racaip\No. 351(,J{
Date ~1t31qq By fJb--
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoning' Ordi~ance ~nd may prOCeed'S requested. This document when
signed by the City Planner coostitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Building Permit Whe1ApPj?J'j
Data s-. J:J '1
I ,
ICI .0 0
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice tor aU inspections 447-9850