HomeMy WebLinkAboutBuilding Permit 09-0313
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS { (j #; 14
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
llNSULATION
INAL
;rE INSPECTION
C MMENTS:
SCHEDULED
LJ;~~f ,....
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
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D/
1
&;- '31~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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,ywORK SATISFACTORY, PROCEED
o CORREC~A nON AND PROCEED
o CORREC R~ALL FOR REINSPECTION BEFORE COVERING
Inspector: I! l Owner/Contr:
CALL l7~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
'7 ('J P $.:? Y
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicant
Permit No.
09, 03/3
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
Ic;61'-/ W/tL-O~J L;lt/VC .5', W.
1. DATE
~/:z/ 09
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT
12. NO. OF STORIES
BLOCK
PID
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
SColT
5. ARCHITECT
(Name)
)-foFF/J7-4Al
(Name)
(Address)
(Tel. No.)
9s;J- q(jO' '2597
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
w
~
~
~
~
':>
v
(Address)
6. i3lo:llo.:E:R (Name)
BEl C .k.7FEltJ~
l.f 0 ~ t<). 6'o/-h .>r
(Address)
IYJI1/A./T U,/i?-r!
M/lL'SJ;'J1/11 SSL//?
Fireplace 0 Septic 0
Alterations 0 Addition 0
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
6/;)- g>t.,/~ 6;;t./3
OCCUPANTS
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
SEATS
16. PROJECT COSTNAb~E
.# /~ ~OO.::;.-
17. COMPLETION DATE
7. TYPE OF WORK
New Construction 0
Deck 0
Finish Attic 0
Re-roofingJ( Porch 0
Re-siding 0 Finish Basement 0
I hereby certify that I have fumished 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;aEbove. ntioned property and that~U co truction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
build If .al ca'Jl:8voke)his perm~ for JUs ause. Furthermore, I hereby agree that the city offiCial or a deSignee may enter upon the property to perfo~ '2eded inspections.
X /U? t:-U~ pI:? ,2Ci;:??'l/ 31 ~/'t--/cJ 7-
Signatu License No. . Date'
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 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... ~
Pressure Reducer .......................... $
Meter Hom... ............... ...... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit.. .................... $
Gas Fireplace Permit ....................... $ Water Tap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $
:~.." of 'kwp'ooy D.re ;;.';~~;~~~i:::::~;fo: Z~~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance rand may proc~~Js requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertifitJof Occupancy must be issued.
City Planner Date Special Conditions tl any
24 hour notice for all inspections 447-9850