HomeMy WebLinkAboutBuilding Permit 99-0895
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
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/O-u-u A-~r-,
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
9'1-?7'5
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
);TF/NAL
/rJ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
-'
~R~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~lfALL FOR REINSPECT/ON BEFORE COVERING
Inspector: T::I:;- f . Owner/Contr:
CALL "'7-9860 FOR THE NEXT /NSPECTlON 24 HOURS IN ADVANCs
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
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DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
JlATF RFr.FJ"F'"l CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicanl
Permit No. qq - 8'1S
2. SITE ADDAES~.y j'
3. LEGAL DESCRIPTION
Jkw..
C_L-_
'~~~
{;',E . A'/)---~ _ ""A/
. r
BUILDING INFORMATION
11. SIZE OF STRUCTU~E
(Height) (Width) (Depth)
25. f'f"l.oo-t-o
R..I~ 0
(Tel. No.) I 14. FLOOR AREA APPORTIONMENT USE
biz-. Y76-767~ J
1_
12. NO. OF STORIES
LOT 'T BLOCK I . PID
ADDITION TtI- <'Mf' St!'t->5 \:S.$ AO'i>
4. .2X'!"ER . ~ (Name) I JAdd,ess).
(f/.lJ~U.f07\ t/f'lJ I/JI'n~~ ~/I-- f'F
5. ARci-UTECT (Name) , (Address)
13. TYPE OF CONSTRUCTION
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
OV/lU--
7. TYPE OF WORK
New Construction 0
Fireplace [)
Alterations 0
Septic [)
Addition [)
Deck 0
Finish Attic 0
Re-roofinQ)r Porch 0
Ae-siding 0 Finish Basement LJ
SEATS
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that r have fUrnished infomlation on this application which is to the beSI 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 conlorm to aU existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
~Uildlng O~~~'~, ju.::"e. Furtheono,e, I he,eby ag,ee that the city official 0' a designee may ente, upon the p,operty to P~~~'ons.
SignaltJre License No. Date
16. PROJC~~ALUE
17. Cd[PLETION DATE
C'
SETBACKS: Required
Actual
fOR ADMINISTRATIVE USE
Front
Back
Side
Side
MA TERIAL FIL~U WITH APPLICATION
SOIL TESTS i:l ENERGY DATA i:l
PILING LOGS 0 PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
("<8;
I
A/I<..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALVA TION
PLANS & SPECS 0
SURVEY i:l
SETS
COPIES
TYPE OF CONSTRUCTION: I II HI IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
2.5Cb. -
PLOT PLAN
i:l
S U
City:
Amount Brought Forward .................. $
ParkSuppol1Fee ........................... $:
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
l.:\.1S
I. z.s-
Penalty ....................................... $
Pressure Reducer .......................... $
Meier Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 70.-
Paid "7 Co - Receipt No. "3> S b eo
Oate 7 I.......... he; By rLO f +-
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Issued
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.
City-Planner
Date
Special Conditions W any
24 hOUf notice for all inspections 447.9850
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