HomeMy WebLinkAboutBuilding Permit #99-0578
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
F16tj/
SCHEDULED I,) -~-'7~
~~IU
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'1?-Srl
o FOOTING
o FOUNDA nON
o FRAMING
o INSULA nON , ./.if)
)'f; FINAL ^" ~ \!]/
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
()y(
t'~#
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
./!~ OWner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl N 7
~~
QA n= R~r.~IVfD.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
';~f'111
L White
2. Pink
3. Yellow
File
City
Applicant
oP9~1
Permit No.
tf'f-S7?J
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
^ 2. SITE ADDRESS
JJj/"'LlI 7",,0'-1.0/ 2,.J
3. LEGAL DESCRIPTION
)!/S'O
BUILDING INFORMATION
11 ^ SIZE OF STRUCTURE
(Height) (Width) (Depth)
"LOCK
.3
12. NO. OF STORIES
LOT
/3
PID z..:-- 3'0 - d~7-o
ADDITION
4. OW~R
I ",_ \
5^ ARCHITECT
~NOI5 #/'--~
13^ TYPE OF CONSTRUCTION
(Namr)
C~f'-J:
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(TeL No)
6. BUILDER
(Name)
(Addresol kLU J{'^ 'f",/~I"j!{I(}!. No^)
IV UI7://'LTC ";') I!:l
6; Si /uel! LoJt'f Pd.
15. NUMBER OF OCCUPANTS OR SEATS
L~ L t'~~..Jv.tlorl h-, C".
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
OCCUPANTS
Septic 0
Addition D
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re'sidin~ Finish Basement D
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES 19. 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 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
~uild~iar can ~v~his ~t for j~~. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform n~eded inspections.
_ /.~ r-:: -z::;;.../tA..-- <;: It;-('C;
Signature License No. Dale
17. COMPLETION DATe
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
B.",
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA [1
PILING LOGS [1 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
ReJ h/ L-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2. So-.nJ _erv'
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division1234 7r.1--1
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. 4:
State Surcharge ............................. ~
/.7...-r
Penalty .......................................4:
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
::;.~~.~~;~i:t;,tY/f~ff1
C""'f~afe of Oocupan{ }
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7(... tfl.)
Paid 1 ,. 0 () Receipt No^ ^3. r ~O y
Issued Date ~ It 1 / f< BY:fi<"---
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.
CityPJanner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850