HomeMy WebLinkAboutBuilding Permit 99-1076
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS / (p c'l >8'
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIONfj)
,r FINAL fi
o SITE INSPEC
SCHEDULED
,
DATE TIME
9-1-'7'1
A- , ".
.
f!~~
CONTR.
INSNOTl
CJ<J - / () 7(,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~.
()
f~ ~ (~Jb
CnMZI ~~ --. ~~
-
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, Owner/Contr:
CALL 447-9S:01oR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
8~R;f;9.
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
<:;9./07'
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITEir~ 1\ 3 e CJ (, \ {'
3. LEGAL DESCR~N V
LOT !/ U BLOCK
Q V' e '\> I"
Qfi r
PID
LPrJ:E\ 106
t"'.4-..e/<-
14. FLOOR AREA APPORTIONMENT USE
ADDITlON
4. OWNER (Name)
irc...^p~ IA
5. ARCHITECT (Name)
O~I" I
(Address)
Ie 0 ~'l' e etc.l ,,(',, H (,
'"
(Address)
6. BUILDER
(Name)
(Address)
r
,. DATE
c,hfJ/qOl
~ \;.. J!/SD
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
7') -()c?h - 6, ~'3-o
13. TYPE OF CONSTRUCTION
(Tel. No.)
t./Jh~h
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEAT~
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 1 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 I 16.. p. R. OJECT COSTNALUE
Chimney 0 Misc. L
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. CULVI:H I :::>lLl:: ,I '11. f.;OMPLETION DATE
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 thaI all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding Off~ ,:r;::~ iAPe(yo~n cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertqnf'r(j r~~s,
<'1"".' _. ~ Signature license No. ' 08'"
I
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING _ /2.F;:S 11' Ie..
FOR ADMINISTRATIVE USE
Back
Side
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF \Alllo:t I nUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
V
R S U
74.75
City:
I . "2A---
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
..~olao"l:c;jii'}~i~~:t;" w;gtd/~1
MATERIAL ALED WITH APPLICATION
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
Z S:O?J _ifV
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WatarTap ................................... $
Builder's Deposit ............................ $:
Other ......................................... 4:
'7(f;.QU
Paid 10. 0() Receipt No. .3 60 ~
Date fib:iq"! By ~
.he above application and accompanYing documents IS In accordance With the City ZOnlng Grdl anca and may proceed as~uested. ThIS document when
.utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
"
Oaf"
24 hour notice for all inspections 447.9850
Special Conditions it any
Total Due .............................. 4: