HomeMy WebLinkAboutBuilding Permit 99-0852
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS j J..j (0 :3 t.{
SCHEDULIiD /0-/ ~-'l' A7:
/1;/LIf>LE: IZ-'l::Ge: ~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
ct1- 'if' -s- z-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~
Jls FINAL
o SITE INSPE
COMMENTS: 4
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
I(rwd -" ~
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L:K SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO)r. CALL FOR REINSPECTION BEFORE COVERING
Inspector: m ( Owner/Contr:
- /
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
~~
~l;/;r
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
V
1. White File
2. Pink City
3. Yellow Applicant
Permit No.
9f-B5Z--
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print Of Type and sign at bottom)
2. SITE ADDRESS
/~34-
3. LEGAL DESCRIPTION
Jq
C!A,.e,e/ A9b #/t..-t-S
4. OWNER (Name)
SI#fW/I/ /-1;t)#ff1/eV
c
5. ARCHITECT (Name) I
1. DATE
l3Ie 1 DL-6
/C..ID~6
~/'-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK.
/
PID Z5-ZBfc.0J1-0
2 AlP
13. TYPE OF CONSTRUCTION
ADDITION
(Address)
(Tel. No.)
tM - 91"/
(T.1. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT"
7. TYPE OF WORK
New Construction [j
Fireplace [j
Alterations [j
Septic 0
Addition [j
Deck 0
Finish Attic Ll
Re-roofin~ Porch C'l
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS \10. 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 Pi erty and that all construction will conform to an existing state and local laws and will proceed in accordance with submitted plans. I am aw re that the
bUildin~ r.v is p. 0 caus.. Furth.rmm.. I h.r.by agr.. that the city official or a d.sign.. may .nt.r upon the property to p.rt n. ed ins io
17. COMPLETION DATE
license No.
Signature
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS C'l
USE OF BUILDING
RI=- S Aj..e.-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
BUILDING DEPARTMENT VALUATION
PERMIT VALUATION
2b(.}(..I.6D
PLOT PLAN
o
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... 4-
SAC ......................................... ot
Collective Street Fee .......................~,
Sewer Tap ................................... $
$
74.75
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
j. Z-!!:;-
Sewer & Water Permit ...................... $
~"Pt;ip;.~"7/-rfrJ
C.rtilicat. of Oo;~l'
Total Du. .............................. $ /(,. trV
Paid 7h.OO Re<:.iPtNO.3~3'(..,
Issued . -. b. ~
Dat. 7 "/ ~.., By .
This is to c.rtify that the requ.st in the above application and accompanying docum.nts is in accordanc. wilh the City zon~dinanc. and may pr s requ.sted. This document wh.n
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.
Pressure Reducer .......................... 4-
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... <\"
WaterTowerFee ........................... ot
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Plumbing Permit Fee ....................... <\"
Mechanical Permit Fee ..................... $
City Planner
Date
SpeciaIConditiQ(lS~any
24 hour notice lor all inspections 447-9850
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