HomeMy WebLinkAboutBuilding Permit 99-1121
o/;;;.~
Cr~+ ~\trA- l2d
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
.~SULATION 0 SEWER HOOKUP
~ ~~NAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: l2o:i f:~~.
~~'
~ ;; -
, <~;A l~-.h,
'- (l~~ ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDU~ED
AODRESS
l\e50
OWNER
CONTR.
PHONE NO.
PERMIT NO.
TIME
AT
C1q -((2..(
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
--..........
-
~
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~~CALL FOR REINSPECTION BEFORE COVERING
I nspector: I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Chimney [j Misc.
18. PROPERTY AREA OR ACRES 19. 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
abov m ntioned 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
iI 0 ca ke~ permit for just cause. Furthermore, I hereby agree thaI the city official or a designee may enter upon the property to perform needed inspections.
:~,. ()~~~t\. ~-'\-<::t"
- Sign~re License No. Date
~~
;)~m
CITY OF PRIOR LAKE
BUILDING PERMIT,
,EMPORARY 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)
12L\i~; \: R~\"T ~\\\'UL ~~
3. LEGAL DESCRIPTION
1. DATE
~-~- '1 q
/22-
LOT
BLOCt<
PID ZS-{)() 1- O/2..-()
ADDITION 1'16765 AND 1'5(){/Jl/DS
14.-Q.W~Elfl.. ~ (Name) \ It (A~e~S)~ - 0, \ ~ o-~o.) 41..\1:)-
'\":::0\-::' ,~~tiL- -r.<:"{,SO ~\-:J \ \ lo..,\'\M,-\.1...) LO~"'"
.
15. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
'1~?t~\>J~G~ ~Ptlc~dOD D~;~~Re;~g~ '{~~~~~
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
1. White
2. Pink
3 Yellow
File
City
Applicam
Permit No.
9.t;:l ~ 112 /
~. .,_.if'
- ',.'~.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (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
MATERIAL FILED WITH APPLICATION
Amount Brought Forward .................. $
Park Support Fee ........................... q:
SAC ......................................... $
Collective Street Fee .......................!t
Sewer Tap ...................................!t
$
Pressure Reducer .......................... $
Meter Horn ........... ................. ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builders Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid --Z ('.(}D
Date q/ql'lq By
SETBACKS: Required
Actual
Back
Side
Side
Fronl
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
z'f7J7J _ dO
USE OF BUILDING
RE S file
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:
7<17>
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ............. ~
/."2...\
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... ~
Sewer & Water Permit ...................... $
~1:Ilil:;tiii;;~~i~~.i:t;, wq;fi:j4%
Certificate of rxeJancy
Issued
SOIL TESTS
o ENERGY DATA
o
PIUNG LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY C]
SETS
COPIES
PLOT PLAN
o
7b.o 0
3&088
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 ..,~" '" .... ,yd. Before occupancy, a Certificate of Occupancy must be issued.
24 hour notice for all inspections 447-9850
Special ConditiOl1s W any
City Planner
Date