HomeMy WebLinkAboutBuilding Permit 99-1010
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
q-;;)tf..LJ? A, Ii
.-
ADDRESS
/1 (p 7'-/
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSULATION A)
~FINAL ~
o SITE INSPECTION
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 GASLlNE AIR TST
o
COMMENTS:
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOvCALL FOR REINSPECTION BEFORE COVERING
Inspector: . 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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DATE RECEIVED
AUG '1_
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
,
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
.
BEFORE PERMIT IS ISSUED (Please Print or Type arid sign at bottom)
6. BUILDJ{ {#1Q. (Nam't.wll IltJf<?r
t(3q~ ~I/(>I..,.
7. TYPE OJ: WORK Fireplac-e 0 .
New Construction 0 Alterations 0
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 fumi ad' form lion 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 prope an at nstruction will conform to all existing state and local Jaws and will proceed in accordance with submitted plans. I am aware that the
bxUilding official c~AOke it . Furthermore, I hereby agree that the city official or a~signee may enter upon the property to perfJiTl nejded inspections.
1/'1.. bY1 r:",{C( X..../,<.ty: q
, License No. -" Daie'
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.1/[
SepticLl
Addition CJ
2 SITE Ail//, 7 L/
'Ih /J'LJ/v
/
3. LEGAL DESCRIPTION
LOT I 3 BLOCK J
ADDITION Ol'n<l-.~Nt> !'J~
4. OWNER B l1~Name)
73 (J 'L 4'''' '1
/
5. ARCHITECT
(Name)
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~ J A-';'
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
13.TY(?;~:r
14. FLOOR AREA APPORTIONMENT USE
If't2...k/'. ~
Amount Brought Forward .................. $
Park Support Fee ........................... ~
SAC ......................................... ~
Collective Street Fee ....................... ~
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn... .... .... ................. ....... ~
Water Meter ................................. ~
Sewer & Water Connection Fee ........... ~
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ......................................... $
Total Due .............................. $
1. DATE
Tr/tJ S~,
f "'/6- 90;
j1 L f?-/SP.
PID
'1 r-Ii ADi).
'1.S./H-o/s'o
(Address)
W71/
(Address)
(Tel. No.)
M r/' 7~~I.(NO~
(Tel. No.)
447-2.1' y 0
DeckLl
Re.roofin~ Porch LI
Re-siding LJ Finish Basement LJ
Finish Anic LJ
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~: ~_nrJ
City:
7tJ./~
/.L.~
ur Building perml~hel Approv~'J
Date - !..---~/
Issued
Paid
Date
I. White
2. Pink
3. Yellow
File
City
ApplicaDt
Permit No. 41- /010
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7'OOd, --
17. COMPLETION DATE
y.../? Y"9
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
ic". -
Receipt No.
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.
By
City Planner
24 hour notice for all inspections 447-9850
Special Condilions n any
Dale