HomeMy WebLinkAboutBuilding Permit 99-0980
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
/" -2z.-'7J. A.r:-
OWNER
ADDRESS ~ d-d.. 9
c~~w.
CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
Jdj FINAL
/0 SITE INSPECTION
COMMENTS:
PERMIT NO.
99 - 9Plf
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 ~LINE AIR TST
~ "7
~
/-kJ
C (</~ ~)~
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: 0- . Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
-".~---_. --------".-.____~.u____
~~
si;~ft;
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEJIIIPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9C?9#0
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADORESS
<"7 "2 "! U.A/,o/J
1. DATE
r lIt? /fV
. "KIst:.
f/2)CJL l~-r' S5~ 7':'
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
2-
rIL
BLOCK c?--
/A r.,c;- S /06
(4_O'v~
LOT
ADDITION
'4?Rt/<. /lP'd.JA/-K
5. ARCI-lITECT (Name)
6. BUILDER
(Name)
7. TYPE OF WORK
New Construction i:]
Fireplace ~
Alterations 0
Septic 0
Addition 0
12. NO. OF STORIES
(Address)
PIC ~-055 -02-(-0
MA"NO/Z-
(Tel. No.)
~~-~7)7
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
13. TYPE OF CONSTRUCTION
(Address)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT"
Deck 0
Finish Anic 0
Re-roofing 9'" Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I 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
the above mentioned property an~~III::onstruction will conform to all existing state and local laws and will proceed in accordance with submined plans. I am aware that the
:uilding Off~iS pea~ cause. Furthermore. I. hereby agree that the city official or a designee may ente< upon the property to pe~i"i:-/;?""s,
,V~ €~ ~ UcenseNo. Date
17. COMPLETION DATE
SETBACKS: Required
Actual
Fron'
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
,eE 5 #'/ /e-
,
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LJ PERCOLATION TESTS LJ
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
~ .r"VU ...-V"
PLOT PLAN
LJ
TYPE OF CON$1RUC110N: I II III IV V
Occupancy Group A B E F HIM R S U
D",~" 1 2 3 4 7.J.1\'""
Permit Fee ................................... <t.
Plan Check Fee ............................. <I:
State Surcharge ............................. 4'
Penalty ............................... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... It.
Sewer & Water Permit ...................... <I:
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
I. z,>
Pressure Reducer .......................... $
Meter Horn ................ .... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
e It.. .................... <I:
Th~ n ~y d,ngperm,whej"Ppflfl
By Data ~ 1(,/
/ I
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ -J tJ . r/G/
Paid 7 (p . (/l) Receipt No. -:? s.- J' S"L...-
issued Date ~/, V / C( Q; By f1L
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning' Ordin~nce and may proceeIJ.s req:ested 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