HomeMy WebLinkAboutBuilding Permit 99-1138
CITY OF PRIOR LAKE
INSPECTION NOTICE
SC,HEDULI!1J
DATE TIME
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ADDRESS
4+11 [).I?l~ m sr.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION {@
FINAL /Z46~
~~ITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
."..
-a e.:h:,
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO!JK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:~' . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
-_.~_..,-_._..,-_.~.----'
~1
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
9';/5/91-
Permit No.
qq~ / /3f3
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
i./ ..; / / /...7_ A- C! 7.; s 7- ...$". ~
3. LEGAL DESCRIPTION
8
7"12 /012 Aee.E3
1. DATE
9 -/_S=9~
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
.3
PID 25-601':, - {Jfb~O
13. TYPE OF CONSTRUCTION
ADDITION
4. OWN!,: (Name) /,J; (Address) (Tel. No.)
-L" ,f'> /~ C",. f ,),,//
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace CJ
Alterations LI
Septic [J
Addition C1
Deck 0
Finish Attic 0
Re-roofing V- Porch 0
Rs-siding 0 Finish Basement CJ
SEATS
New Construction CJ
Chimney 0 Misc.
IS. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that va furnished information on this application which is 10 the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for
the above mantia ad property and that all construction conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
bxUHdinijllfficial rev ermlt for just ca S6. Fu ermor~gree thai the city official or a designee may enter upon the property to pert~ needed inspections.
U, /.A'/L 7 ~~~c.
license No. Dale '
16. PROJECT COSTNALUE
17. COMPLETION DATE
Signature
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
RES ~/e
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS LI
SURVEY 0
SETS
COPIES
zs-6D, cIV
PLOT PLAN
LI
TYPE OF CONSTRUCTION: 1 II III IV V
Occupancy Group A B E F H t M R
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ......... ................. ............. $
Plumbing Permit Fee ....................... $
S U
City:
Amount Brought Forward .................. 4'
Park Support Fee .... .... ................... <t
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
,
74.75'
/.7....1
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WalerTower Fee ........................... $
Sewer & Water Permit ......................:t
GTl1a'SSFir~lacePBrmecoit J'e.s~.:~}A~:d.,..n.g..p..e$rml.tW~he~p"9"edZJ Water Tap ................................... $
t ~ /' / Builder's Deposit ............................ $
By ~ Date ::r: '1 O1her ......................................... $~
Certil;:te ot OccupJncy / Paid T01;oZ :O.O...........~~~~I~iA ; (P;~/O
:,::,0 certify that the request In the above application and accompanying documents IS In accordance With 1he c~:;o"'ng~~~!.:,ay pr~ ~~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.
CilyPlanner
Date
Special Conditioos ff any
24 hour notice for all inspections 447-9850