HomeMy WebLinkAboutBuilding Permit 99-0799
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEpULED
/O-2Z.-'l'P k T;
ADDRESS
S?L/s- ~ ~
OWNER
CONTR.
PHONE NO.
9C;-?'17
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
RI FINAL
f 0- SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
A MEcH FINAL
K~~~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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COMMENTS:
~ .. . ~-........
(' (lfI~ ~
-
-
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORAALL FOR REINSPECTION BEFORE COVERING
Inspector: V7 f ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
q9- 79L
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDR~ ,; /' /.....- ..-."-- / J I" .'
.5 .,.5 _c L- SlaA ul"J ''../
3 LEGAL DESCRIPTION ~
LOT .3 _ BLOCK /
ADDITION /S~.qN.o v/e:W 2
;;7~S791
(K I ,kIStJ
BUILDING INFORMATION
11, SIZE OF STRUCTURE
{Height} (Width) (Depth)
12. NO. OF STORIES
PID 2.5-/s"1- tJ1I3-0
13. TYPE OF CONSTRUCTION
4,O~1-~J,.JNam.) !torOP ~7'~";ddreSS)!
5. ARCHITECT (Name) I
Ci~'~(X)Jll
14. FLOOR AREA APPORTIONMENT USE
I
I
6, BUILDER (Name) (Address) (Tel No) S l1~eda;dNUMBER OF OCCUPANTS OR SEATS
7, TY'1!~~K ~~r.~e~;~,~~ I1fl.sbdi;h:: 5f~ssLO 55/~:::ANT~
NewConstructlonLJ AlterationsCl Addition 0 FInish Attic 0 Re-sidlngO FmlshBasemento /16. PROJECTCOSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE ," 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished info ation on this application w ich 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 p rty and at nstruction will nfo all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~Uild;ngOffic;alca{;VO th; e I 's' se. Funh ore, h rebYagree'haltheC;'YOff;da~o71"J:.rd,,~propenytop~~~~e._
License No. - , Dat'8/
- -
-- --
FOR ADMINISTRATIVE USE
(Address)
(Tel. No.)
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS CJ PERCOLATION TESTS CJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
A!:6 S ~/.t"_
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS CJ
SURVEY CJ
SETS
COPIES
ZS'?5V. VV
PLOT PLAN
o
TYPE OF CONSTRUCTION; I II III IV V
OccupancyGroup A B E F HIM A S U
City:
Amount Brought Forward .................. <t
Park Support Fee ........................... $
SAC ......................,.....,............ $
Collective Street Fee ....................... $
Sewer Tap ................................... $
~
Pressure Reducer .......................... .11:
Meter Hom ........................ .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
7.f.1~
/.l.-)
Penalty ...................... ......... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..... ............. ... $
Sewer & Water Permit ...................... $
;15 n er,"" ..e:*~~~:,;.~f7~
., f
Certificate of Occu ancy
Water Tap ................................... $
Builder's Deposit ............................ $:
Other ......................................... $
Total Due ................,............. $ .., (,. uti
Pa;d 7~. ~ Rece;~._ :!:.S57 Z-
Issued ~.
T. . 'Iy th . th bo app" d ' 'd ., rd .th h cDa'ze '102rd-:~~q~ BY.1, .
hiS IS to certi that e request In e a va lea on an accompanYing ocuments IS In acco ance WI t e Ity onlng Inance ana may procee 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 Certifi e of Occupancy must be issued.
CityPJanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850