HomeMy WebLinkAboutBuilding Permit 99-1018
CITY OF PRIOR LAKE
INSPECTION NOTICE
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ADDRESS
OWNER
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CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ._ -/1 f1fI
~ FINAL /1q ~ \(]I
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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COMMENTS:
DATE TIME
i~- <f>-~ ~
7'1-/O/,X
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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VORK SATISFACTORY, PROCEED
~~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION eEFORE COVERING
./'J~ Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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INSNOTJ
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DATE RECEIVFD
a/ 17/'1<7"
-
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
91-/0/8
2. SITE ADDRESS
3/
3. LEGAL DESCRIPTION
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v
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Address)
[Tel. No.)
TION
LOT
BLOCK
PID 26-0" 1- on (,-0
/'7/7/\/oe j<Sr
ADDITION
L. ,,-tr,cESIOb
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
[Tel. No.) f: !;'3-5;;(.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
p
Fireplace CI
Alterations CI
Septic CI Deck CI
Addition CI Finish Attic 0
v ,.U
Re-ro~fin..iP- Porch CI
Re-siding"'" Finish Basement 0
SEATS
7. TYPE F WORK
New Construction CI
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
-
Sq.Ft.
I hereby certify that I have fumished infonnation on this application which is to the best of my knowledge true and correct. I also certi that I am the owner or authorized agent for
the ab~V~uZ;':~ed property and that II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildi ~n revoke t' e it f just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertonn needed inspections.
r .' Signa,",a U~.. No. 0."
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS (] SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~E3 /f/ /2.-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City'
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
74 ir
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I ",Y
$
Gas F.ire
I'ling ~:.:,It hJt1J!/C?
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid Receipt N
--"/(" 0 0
3S-fli\
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & WaterPennit ...................... $
This
By
Certificate of Occupancy
Issued
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin ce and may proceed s 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 hour notice for all inspections 447-9850
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