HomeMy WebLinkAboutBuilding Permit 99-0815
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDI)'l..ED
DATE TIME
la.u.n 4'71
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~
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99 -J>I5'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA;jJ,IN..:J'IR TST
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~LL FOR REINSPECTION BEFORE COVERING
Inspector: IV I, Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
S~1
/
DATE RECEIVED
t,/30/'?'7
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.
C?9-%/c:;-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ~/I /J A/\ Ai -
't{ nl.f ~..JJ) (' /uIYf. -----rY / f:
1. DATE
11l'if) -99
fi2/S.o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
4-
LOT
BLOCK
C;;JI2"1//V /1/000
I
h'7S.
12. NO. OF STORIES
PID ?C;-o!'J9- 00.(.-/
ADDITION
4. OWNER
13. TYPE OF CONSTRUCTION
5. ARCHITECT
'alii r; I (T;L1O '~:J1_
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
4d fi1 (eM I
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
5Jf7Ll
oS
oJ b~ .v;:e
7. TYPE OF WORK
New Construction CI
Chimney CI Misc.
S. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that J 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 m ntioned 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
i1di off I c;4n re~o~is permit for just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed ins~ions.
IltCUI 6 '..j[)-7;
Signature License No. Date .
Fireplace CI
Alterations CI
Septic LJ
Addition CI
DeckCl
Finish Anic LJ
Re-roofing'1l Porch LJ
Re-siding CI I Finish Basement CI
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPlICA nON
Front
Back
Side
Side
SOIL TESTS
CI ENERGY DATA
o
.ees #/~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z.m.cV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H r M R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. c-
Park Support Fee ........ ................... $
SAC ......................................... <I:
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
-'/L/. 1r
1.2.)
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Ham .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This ~JjBeimef'/j.A,uilding Permit Whenh~o~
BY~~ Date~/~/"
Certificate of Occupancf
Builder's Deposit ............................ $
Other ......................................... <I:
Total Due .............................. <I:
Pa;d -Jt-. (/7/
Date ~/10/'t1
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certific
Issued
CRy Planner
Date
Special Conditions ij any
24 hour notice for all inspections 447-9850