HomeMy WebLinkAboutBuilding Permit 99-0962
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
jD-n-9? A.I:
ADDRESS
c:?9~ 0
T~&
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)ll'"FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
9'J-<J6 C-
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 GA~:~ ~R TST
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R~~~
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEEO
o CORRECT WORKiALL FOR REINSPECTION BEFORE COVERING
Inspector: W- ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No.
QQ-Clb2...
1. DATE
/2. SITE ADDRESS 2.l11.1 0
3. LEGAL DESCRIPTION
./,
~JlMiL
~ 0.W
g'02' 1'1
~ I,sD
BUILDING INFORMATION
11. SIZE OF STRUCTlJHE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
PID .2.<;-/.$3- OOP,-I
/,?,c:;?E;S //M? ~ouN'DS
/4 OWNER fu,tmth'",f j) i It\
15. ARCHITECT (Nallie) (Address) _ " (Tel. No.)
6. BUILDER. (Name) (Address) qvr n'IVm MIV. (Tel. No.)
.~ ~;~_~e,~g:p~~~~
(Address) l .. I S lit (Tel. No.)
tq{;()O ftvrtJ.u.- UYub .w.
13. TYP~X:Z;VhCTION
14. FLOOR AREA AP~RTIONMENT USE
ADDITION
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc. lpl' 'I ~
8. PROPERTY AREA OR ACRES 190 PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq.Ft. Width Depth Yes No ~: .....~ g.:5. '19
t hereby certify that I 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
at all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
IS. Furthermore. I hereby agreZOthj ~ ~a~r a~~ee may enter upon the property to p;r~ ~e~qCfections.
IQnature License No. Date
the a 0 e mentioned~O rty
buildi 0" r this
X /
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
- BUILDING DEPARTMENT VALUATION
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
.eBS A/e
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2.500.00
PLOT PLAN
o
TYPE OF CONSTRUCTION: I " III IV
Occupancy Group A B E F HIM
V
R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ............. .... ...... $
Sewer Tap ................................... $
$
Division 1 2 3 4
'7#. 75"
Permit Fee ........................... .... .... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.................. ..................... .0;:
/.2.5
Gas Fireplace Permit ....................... of:
ThIS..ad.., ,/.~m/Y~lng Permit Wh7f.Ap1~
BY~7'~A.. Date ~ "
Certificate of Occu,"cy
Pressure Reducer .......................... $
Meter Horn ................ .... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Total Due .............................. $ '7'fn.OO
P.,d -?~. 0 C> Aece,ptJllr;; .if'> l'3.3lO
Issued Date t,B!<J>./C?9 By 1JJfI
ThiS IS to certify that the request In the above apphcallon and accompanYIng documents IS In accordance With the CIty Zomng Ordinance and may proceedbeq-uested 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 if any
24 hour notice for all inspections 447~9850