HomeMy WebLinkAboutBuilding Permit 99-1161
o FOOTING
o FOUNDATION
o FRAMING {?
o INSULATION
,,5 FINAL
o SITE INSPEC ON
COMMENTS: ~.
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~~71~
OWNER
PHONE NO.
DATE TIME
SCHEDULED
(c,./L/-'J9 A.T.
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t!J~(~ w,
CONTR.
PERMIT NO.
9'7-1/~1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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L SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . Owner/Contr:
, J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSHOTl
QA~ l=U::r.~jVI=D.
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
Ci.ty
Applicant
Permit No.
9q "'//6, /
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
"l.,Lj<;(q W;\I flW "RrorJ"
1';i~~I'1~
Trad ,e/Jp
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3, LEGAL DESCRIPTION
LOT 7ilZ~ A
12, NO, OF STORIES
BLOCK
PID ,2S -/07 - O()2. -0
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER I _ (Name)
:<\ 1"'l"ph/JI v"\
5. ARCHITECT (Name)
IO~O
(Address)
(Tel. No,)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
6, BUILDER
(Name)
(Address)
(Tel. No.)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~r(us<(
7, TYPE OF WORK
New Construction LI
Rpo fi oq
SepJil1Cl
Addition LI
,
SEATS
16, PROJECT COSTNALUE
Fireplace 0
Alterations LI
DeckLl
Finish Attic LI
Ae-rooflng.JS...-., Porch 0
Ae-siding LI Finish Basement LI
Chimney LI Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVEAT 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
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 cBf Y',:oke. th1 pe,gnit for ju~ ;au~e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
X ~)tM~..O~./~_ ,Qr1i::J-::"i., '" "/~::Jlq,
, Signature Ucense""No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
..ok
Side
Side
SOIL TESTS
Cl ENERGY DATA
Cl
USE OF BUILDING
~ A/.e-
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
PLANS & SPECS 0
SETS
COPIES
SURVEY Cl
PLOT PLAN
Cl
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
City:
Amount Brought Forward ..................!t.
Park Support Fee ........................... ~
SAC .........,............................... $
Collective Street Fee ....................... ~
Sewer Tap ................................... <t
$
Division 1 2 3 4
Permit Fee ................................... $
74. 7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty. ...................................... $
I. 't-r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... cr
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ~
WaterTowerFee ........................... If:
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
~is!hit-l16~!.ldlng ~:t';"~J{Ap~'1
CertIficate of Occupancy
Water Tap ................................... t
Builder's Deposit ............................ $
Other ......................................... It:
Total Due .........,.................... $ 71'...00
Pa,d 'l~.W Rece'Pt~~o 3(, -z.tf/
Issued
Date 1'h.1j'i1 By /'..
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' ~uested. ThiS document when
signed by the City Planner constnutes a temporary Certificate of Zomng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Date
Special Conditions if any
24 hour notice lor all inspections 447-9850