HomeMy WebLinkAboutBuilding Permit 99-1084
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
r; ~{'X)
OWNER
PHONE NO.
J~AtJ1 TIME
SCHEDULED ~ ~
~ k1r i?AJ
CON;R. f-._ ~
o PLU;:I::I:I~ IE~~:nl.lI' I~
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
o FOOTING
o FOUNDATION
o FRAMING @
~SULATIO
FINAL
SITE INSPECTIO~
COMMENTS:
" l
I),t>>{ ~ G~'
,]0 "''':Aea''::>.
p';-;-~ Y1
- ../
---- -
~ -
L'TI"~~"~~"
o CORRECT ACTION AND PROCEED
o CORRECT WOf' CALL FOR REINSPECTlON BEFORE COVERING
Inspector: 0-l-~ OWner/Contr:
CALL 447-98SJOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
~~
~7;/9~_
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9'1-/()gt)
1'~r{_~9
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
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Hei~t) (Width) (Depth)
S}t;()
LG..l'r;o.M- \-\ J \
12. NO. OF STORIES
3. LEGAL DESCRIPTION
LOT
3
NO 12TH
..s~~6
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
BLOCK
ADDITION
4. OWNER /<. (Name)
Unfl'1
5. ARCHITECT (Namb/
rlo
6. BUilDER
(Name)
Go-.\~
7. TYPE OF WORK'
New Construction 0
Chimney c:J Misc.
~e.(I~n
Fireplace 0
Alterations c:J
17. COMPLETION DATE
?A
U('~dr LcJz-t
2-
O/J,t::.S
PID 25-259- t7r;q-()
5711
13. TYPE OF CONSTRUCTION
(Address)
If fxJ I)--t.-
(Address)
(Tel. No.)
tc.l>'-<iC+l~8"ess) !IfP/-<. Vo.-ll"1 (TeL No.)
l3(,,1S- \\0..0.'.0\1...../.. d-- ftIJ-117-;)701
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Septic 0 Deck cr
Addition c:J Finish Attic 0
As-roofing'" Porch 0
Re-sidlng 0 Finish Basement c:J
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. 1 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 official n revoke this ermit for just cause. Furthermore, I hereby agree that the city official or a des,!,gnee mavnter upon the property to perf~ 7ed~ jrspections.
X 'h-:')cJ-y/ ZO/ 3lzq~ ...-- '1--17
Signature License No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
pt;s A/"""-
TYPE OF CONSlllUC11ON: I II III IV V
Occupancy Group A B E F HIM
Division , 2 3 4
PelTl'lit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLlCA nON
Back
Side
Side
SOIL TESTS
c:J ENERGY DATA
o
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2m.. crv
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
R S U
City:
Amount Brought Forward .................. It
Park Support Fee ........................... It
SAC ......................................... ~
Collective Street Fee ....................... <t.
Sewer Tap ................................... II:
$
?'-/_ 7 r
/.-z.J
Pressure Reducer .......................... ot
Meter Horn ................................... tI:
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Buikler's Deposit ............................ $
Other ......................................... $
Total Due ............................... 'liP.O (j
Peid 7{; ,0 0 Rece~PtN. 3(,ot./1
Issued
Date .~/~ By ~A--
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 ~ 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.
~~:~:r~~;I~I~~i:t;"w<rrtq~_
Certificate of Qccupanj
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850