HomeMy WebLinkAboutBuilding Permit 99-1044
~\Q
DATE
(J---.5 -~~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUI,.ED
ADDRESS
5900 '0~ T/\,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'1 '1- /OiY
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~ ~ t1A1
~ FINAL =~I '\(t/
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 GASLINE AIR TST
o
COMMENTS:
()j(
~~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
~
Owner/Contr:
gALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
_. .~.._..----- " --..-..-.--.--..---------.--.-.--...------
&~~
;7;/~1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
AppliclUlt
Permit No.
9C/ ~ /6 -It
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2~~CDE~<<,W'1{' _
dtJtq)q~
K-I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Haight) (Width) (Depth)
3. LEGAL DESCRI~N
LOT
I
12. NO. OF STORIES
BLOCK
PID z.,. - 'G:z. S- - 003'-0
AODITION A/OcJ DL/T'W AJ
4.~ ~ ~ lY'nit""
5. ARCHITECT (Name)
H13
13. TYPE OF CONSTRUCTION
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
6. BUILDER
(Neme)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction [""J
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Fireplace 0
Alterations [J
SepticLJ
Addition [j
Deck 0:
Finish Attic ("J
Re-roofing~ Porch 0
Ae-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
190 PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
t 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
roperty and that all oonstruction will oonfonn to all existing state and local laws and will proceed in accordance with submined plans. J am aware that the
re 's permit for just cause. Funhermore, I herebY. agree that the c;ty off;dal or a designee may enter upon the prope"" to ~'l:Q AD-'
~Iure License No. I q
'. 17. COMPLETION DATE
x
'-'
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
MATERIAL FILED WITH APPLICATION
.aok Side Side SOIL TESTS (] ENERGY DATA (]
OFF STREET PARKING PILING LOGS (] PERCOLA nON TESTS (]
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY (] COPIES
PERMIT V ALUA TION Z. stfU.. rn..-- PLOT PLAN (]
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
1'-0 ,If- / /C...
TYPE OF CONSTRUCTION: r II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pennit Fee ................................... $
7..(. '1r-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... t
Plumbing Pennit Fee ....................... t
Mechanical Pennit Fee ..................... $
I. '--,...
Sewer & Water Pennit ...................... $:
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ '7 fo.() D
Paid 1(" ~ 0 Receipt No~ '3"(,013
Issued .-{1-/J
Th~ is to certify that the request in the above applk:ation and accompenying documents is in accordance with the c:;oning Ord~ an; ay proc: ~uest~ This document when
signed by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be Issued.
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
---'".-..-..---.. ~'--~--------..~_. -'-,~.~---,-,---_.. _.~.---~_.._._._.__.._..__._..._------..-