HomeMy WebLinkAboutBuilding Permit #99-1041
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
10 -1..Z -'1 "}
,4, T,
ADDRESS
4tJ3J-/
,e~ --1.;.,
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
III FINAL
10 SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
94-10<-//
o PLUMBING RI 0 EXlGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL )1.. 4
K~ ,;" ~
(' (:f:-- ~_).
/
~ORKSATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: i/;+, Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOT1
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
l. White
2. Pink
3. Yellow
File
City
Applicanl
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No. 9t!f - / (j t..f J
1. DATE
ADDITION
I:)LOCK
.!;;p,e /,N6i
BeOo,K:::.-
B --- Jo- qq
6t- SF;, Prlry I~ R/-w1
PID 25-099-nn3-0 I
PI7,€./C- I
. (Tel. No.) ~-44io~
UI)"::>lf-~ M~!<l-: 51=:' 1
(Tel. No.) I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE 4t)~Lt
'Knru\ote
3. LEGAL DESCRIP1]PN
LOT 4-
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
4. OWNER (Name) ~dreSS)
. Wl'll1a...tn ('){"" S~ h \'"1M J )I.ti:J.('t:..
5. ARCHITECT (Neme) (Address;
14. FLOOR AREA APPORTIONMENT USE
6, BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER Or Ul,;l,;UPANTS OR SEATS
7. TYPE OF WORK
New Construction LJ
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Fireplace LJ
Alterations LJ
SeptiCLJ
Addition LJ
Deck 0
Finish Attic 0
Re-roofing^- Porch LJ
Re-siding 0 FInish Basement LJ
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
/9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Width Depth Yes No
that I have furnished information on this application which is to the beSI of my knowledge true and correct. I also certify that I am the owner or authorized agent for
tionEid property a t all construction will conform to aU existing state and local laws and will proceed in accordance wfth submitted plans. I am aware that the
'ar can revoke this permit f I I~~se\ ~tfhermore, I hereby agree that Ihe city official or a designee may enler upon the property to perf~ needed inspections.
'A.lLi..u:- 2S- .::>n- Cia
SgnalurS - License No. Date ':--1--
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
- - - - ----
F"""
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PlANS & SPECS CJ SETS
SURVEY CJ COPIES
PLOT PLAN CJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
R--t5S: p/e
,
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
&- ~ (!()
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
f. ~r
City: Amount Brought Forward .................. $'
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
S U
7Q.7r-
Plan Check Fee ............................. $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ........................ ........... $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
other ......................................... $
Total Due .............................. $ 70. cJ 0
Paid 7 tR . ([{j Receipt No. :3 (p 00 8
Issued . ~ ~ .
Date g c; By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina and may proceed 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.
This :rm/~~.jA'j;I~i~~.~~:,t WJl1 Appft9Cj
By jfr 'PfJfJ(1 Dete "1J vrJ" "{.
I~ I I
Certificate of OccJpancl"
CityPJanner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850
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