HomeMy WebLinkAboutBuilding Permit 99-0625
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEQ
ADDRESS IS IS::L k'07 1:::.<. L
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
I.'! FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
@ 0 WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
4.
~~
~/'
DATE TIME
/0 -N -9.3 It,!.
< ~
T/2t::kf S': t:.. ,
9Cf - Co 2'::;'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~
-
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---"
-
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~O-RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~. CALL FOR REINSPECTION BEFORE COVERING
Inspector: tJ1- ( . Owner/Contr:
CALL 4.1"9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANC~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
--..---
--.-.------.-
New Construction 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 at all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buiJdinQ.2lllcial C8r\?3:IJoke this pe r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X - I'VU..,(~ ?.b._)
Signature License No. Date
DATE FlF(~FIYEO.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MAY L. 6 1899'
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS },..A ~
/5/S::J. ^ (f M.M /1
1. DATE
5--,;)S--91
l2isD
;(") -/&5"'- &/-u
3. LEGAL DESCRIPTION
).
LOT
BLOCK .)
<t1flF1tJ11- /...0....--
PID
ADDITION
4. OWNER
~
5. ARCHITE"lr
(Name)
.5n..u1~
(Address)
. ~AIVLL
(Address)
(Tel. No.)
t..I47-7,,?::J <I
(Tel. No.)
(Name)
6. BUILDER
(Name)
(Address)
7rLikL
~N
~ .J~ CrI.;Joo 01. tltf:l~3Nd
(Tel. No.)
7. TYPE OF WORK
Fireplace LI
Alterations 0
Septic 0
Addition 0
DeckLl
Finish Attic 0
Re-roofin~ Porch LI
Ae-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. C;v - (;.)j
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STOAIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS 0 SETS
SURVEY Cl COPIES
PLOT PLAN 0
SETBACKS: Required
Actual
Front
Bad<
Side
BUILDING DEPARTMENT VALUATION
./1 ^
k..t ~ 111 K..
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H r M R
Division 1 2 3 4
Permit Fee ................................... $
7L/ - 7<;
/,).<)
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /~ ,00
Paid 1(".190 Receip, No. ~ j q"{
Date S" 2J., ..qC{ By 4\0.)
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 req8ested. 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.
S U
City:
Plan Check Fee ............................. $
State Surcharge ............................. .ot
Penalty ....................................... $
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Pennit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Dale
Special Condilions W any
24 hour notice for all inspections 447-9850