HomeMy WebLinkAboutBuilding Permit 99-1072
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/0 -( P'-'J,) A. .r-
ADDRESS
/51tM
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
),!: FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: h;. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that 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
the above mentioned property and that all canst ion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building .. n yoke th' pe . r just cau e Furthermore, I hereby agree th~the ci!j Off.iO"", or a desi~e may enter upon the property to perform needed inspections.
X n-Ol bf:f=1-J5 (!-::J.-:f--97
Signature I license No. Date
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QAT. R.r..'V.Jl CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
- 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
l~/t)O m/hV/7Ga P...b
JJE:.
le:A;~ _qCj
/<.1:5D
3. LEGAL DESCRIPTION
BLOCK '-
,P.1:"PA~ ~(,;76G
(Name) (Address)
&.M.I- SH6LLY MfNj(..~
5. ARCHITECT
LOT
B
PID
;z.S--25s-~-o
I
(Tel. No.) I
"/0-- tNf)-;J.(,...fi4
(Tel. No.) ,I
6 BUI(f.RU1 C...,~7~U.1 t D'i;fls. I1Jc::'eSS) (Tel. No.)
a/f-:f-I IBt.;;T..-{ $.T ~ Pfllbllt.At-r.. (P1d-.-t/tf7--S:703
ADDITION
4. OWNER
s..A.B,
(Name)
(Address)
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Ae-siding 0 Finish Basement 0
I. White
2. Pink
3. Yellow
File
City
Applican!
Permit NO..rt... 1072.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heigh!) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
SETBACKS: Required
Actual
Front
..ok
Side
Side
- BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES AEO.
SPACES ON PLAN
PERMIT VALUATION
Z'>""CCJ
USE OF BUILDING
~
It / t'--
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
<'4.(<)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... ct
I. '2...)
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS 0 PERCOLATION TESTS LJ
PLANS & SPECS LJ
SURVEY 0
SETS
COPIES
PLOT PLAN
CJ
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................ .... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 1C.
Paid r.. - I Receipt No. i ,,"03 7
Date tl fz.. -r fqc; By MH
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and'may proceed as 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.
Certificate of Occupancy
Issued
CilyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850