HomeMy WebLinkAboutBuilding Permit 99-1056
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
<'t~ft1 A.T.
652/ LosT /-IO/2./20N ~
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9'9- /0670
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
Jl1 FINAL
10 SITE INSPECTION
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
m ~ GASLlNE AIR TST
"-!.r ~or
~:~. (J-r..R.:i'.-,
~~~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
LRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wl}fK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: f~ Owner/Contr:
I
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
~'t
QATI= RI=r.I=L"~r"!.
8/2-~/ri9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicanl
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No.
9'1 --/osb
1. DATE
LOT
3. LEGAL DESCRIPTION
q
SJ/.&J/V6iIGI
. BLOCK
~-1S;-99
,-OS, H01212CJN 011<<1L6 SE: I
,€ / SD'
PID 2.5-/IbS-02.8-0 I
I
(Tel. No.) "
e.........L...J:. ((,Q) """1-'-'1131
(Tel. No.) I
2..
12. NO. OF STORIES
2, SITE ADDRESS
BUILDING INFORMATION
11. SIZE OF ~ I "~~~E
(Height) (Width) (Depth)
552/
ADDITION
t-A-
13. TYPE OF CONSTRUCTION
4. OWNER
(Address)
')...:;:21 L.....~ ~ (1./r'
(Address)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offici n revoke this permjJ,lor just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed inspections.
X ~:!~ 'o'",'No. 8-L-:r.-9?
I 17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
- - ..-
----.
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.P6~ A/.e.
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
'L..,w. -
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ..... ..... ......................... $
~4. 75
Plan Check Fee ............................. <I:
State Surcharge ............................. $
Penalty....................................... $
I. 2..5'
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ......... ............ $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Sewer & Water Permit ...................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $---2.h. 00
Paid '7~. 0 V Receipt No. 5'(;J)t- z.,-
Date 'P /24/'11 By -fi L2...-.
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 as ~uested. 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.
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
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