HomeMy WebLinkAboutBuilding Permit 99-1118
CITY OF PRIOR LAKE
INSPECTION NOTICE
AODRESS 41 5/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
VFRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
(~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: T ~ (J fI
~~b (~~kJ
DATE TIME
/0-1->-<1'1
4V
101- //(1
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(]t~
;/
Q/(
/
/
/
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0~RK SA
o CORRECT A
o CORRECT
Inspector: _
CALL ~7.9850 FO
Owner/Contr:
HE NEXT INSPECTION 24 HOURS IN ADVANC~
'NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
~~
QATF RFr.FI'lEQ CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2, Pink
3. Yellow
File
City
Applicant
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
1[8 (er,
Permit No.~ - ~ \ 1 ~
4151
CA~~
S-r-.
S.E .
R'2..S.o
BUILDING INFORMATION
11. SIZE OF STRUCTuRE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
1-
BLOCK
LAlce5rf.)6- /!2srA re>
PID
1. '5 - I 8 .3- 0 14-0
12. NO. OF STORIES
LOT
ADDITION
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
VJI'-~~
5. ARCHITECT (Name)
SC.OT"T
(Address)
S' c. H f""\O i<'El-
(Address)
(Tel. No.)
4-40. ~"300
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
<;'~&-
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES
Sq.Ft.
Fireplace D
Alterations D
Septic D Deck 0
Addition 0 Finish Attic 0
Re-roofing"'O( Porch D
Re-siding 0 If Finish Basement 0
SEATS
16. PROJECT COSTNALUE
19. PROPERTY DIMENSIONS
Width Depth
/1 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I h e furnished information Ol}o,fhis appliesti which is to the besI of my knowledge true and correct. I also certify ltlat I am the owner or authorized agent for
the above mentio rope '<:111 WI I ~ttion will rm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building v IS .. se. Fu re, I hereby agree that the city official or a designee may enter upon the properly to perfonn needed inspections.
x. lit
/ License No. Date
,
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
D ENERGY DATA
[J
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
A/,2..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PILING LOGS 0 PERCOLATION TESTS 0
iZ E: <,
PLANS & SPECS [J
SURVEY [J
SETS
COPIES
PERMIT VALUATION
'2. SQ:).
PLOT PLAN
[J
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 :3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park: Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
I. 4.1~
Plan Check Fee ............................. $
State Surcharge ............................. $
\. 'L-"')
Penalty .............. ......................... $
Plumbing Permit Fee ....................... $
Gas
I
i (" k 1
Pressure Reducer .......................... $
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total DUe .............................. $
Paid , . Go . Receipt No. '3" 0 8 4
Issued .
Date i I II I "Ie, By (1.-1) 1-+
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.
This
By
Certificate of Occupancy
,,, .
-=--
CnyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
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