HomeMy WebLinkAboutBuilding Permit 99-0902
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS
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CONTR.
OWNER
PHONE NO.
PERMIT NO.
99, qOz..
o PLUMBING RI 0 EX/GRAD/FilliNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL /;\)J 0 GASLlNE AIR TST
o MECH FINAL ~ )11 ~F
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COMMENTS: (!'j ~_ ~__ ~ ~
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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o ~ SATISFACTORY, PROCEED
;;{"~~~~CT ACTION AND PROCEED
o CORRECT WOR~ALL FOR REINSPECTION BEFORE COVERING
Inspector: fm \ OWner/Contr:
f
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
~~
DATE RECEII1ED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
crq ..q C1 "L..
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1:C;t.L)(f,o ~c.-Li...A\'/_
iliGAL DESCRIPTION
1. DATE
LOT
ADDITION
4.0W~
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5. ARCHITECT
BLOCK
7- ~- 'J"J
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PID 25 -143-0 33-0
(2...\59
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
6. BUILDER
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(Name)
(Address)
~,-
(Address)
(Tel. No.)
440- '\3!;S
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Chimney ('J Misc.
Fireplace 0
Alterations 0
Septic CJ Deck LJ
Addition D Finish Attic 0
As-rOOfing\" Porch 0
Re.Sidin~iSh Basement 0
SEATS
16. PROJECT COSTNALUE
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished infonnation on this application which is to the best 01 my knowledge true and correct. I also certify that I am the owner or authorized agent for
the ab entioned property and that all construction will conform 10 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bui Ing offlc s pe it Just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perlonn needed inspections.
7-Yb-'l'~
""to
17. COMPLETION DATE
x
License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
USE OF BUILDING
rze.;
J
fr-{P-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
BUILDING DEPARTMENT VALUATION
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PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
Slate Surcharge ............................. $
Penalty ....................................... s::
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
'14.1,
f.~-)
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ') (n. -
Paid 7'" - Receipt No. ?,~, I
Issued ,
Date 7 (-z..,;.. !Cfc" By fWlo\-
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 tempora'Y Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertifICate of Occupancy must be issued.
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ate -/-./7 6. Iv~
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Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Plumbing Permit Fee ....................... !I:
This
By
CijyPlanner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850