HomeMy WebLinkAboutBuilding Permit 99-1213
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDU..ED
DATE TIME
/fYI i(-q<}
.4-. T:
ADDRESS j(p 3fr3
~~.~,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
fsl FINAL 0 PLUMBING FINAL
tr- SITE INSPECTION /J 0 MECH FINAL
COMMENTS: /JK~
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-
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
d'ff1--L-
- ,
L SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOD).ALL FOR REINSPECTION BEFORE COVERING
Inspector: l OWner/Contr:
V
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
- -~---,._._-~-'- --_._.._-....------_._-,._~----.-_..
~~
DATE RECEIVED
/c:J/-;- /'11
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
~'1- /2-/3
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
lolsl'l'i
2. SITE A[t~~ <(3
3. LEGAL DESCRIPTION
lJ O'l+V\vJroc.(
Rt1
1< Up
BUILDING INFORMATION
11 . SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
&/
BLOCK
PID 2.5-J'l-I-()38-0
ADDITION
4. OWNER
('ll: \
(Nam.)
p., (' () \~ I ("\.
/V 0 J<?- 77"1hI 00 0
\i::~~.." Nodh . ~c.t (T44d-1~8-()
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
hn~V5('{ ~"1
7. TYPE OF WORK Fireplace [j../ Septic [j
New Construction 0 Alterations 0 Addition 0
Chimney 0 Misc.
i.fCf J-. - 3rg Y;;L.
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. J 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 c:~ermit for just ~erebY agree that the city of~ial or la designee ma:rter up. on the prop~rty to perform needed inspections.
X ~t -!#..,,- .-/ <- ;9; rJ ~ ,,~OI:2317.5 1O/.::J/'1"'J
, Signature license No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
Ll
/CES H//Z-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY Ll
SETS
COPIES
"Z- >VU _ c./L)
PLOT PLAN
Ll
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ............. .............. $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ...................... ......... .... $
1'/71"
Plan Check Fee ............................. $
State Surcharge ............................. $
J. 2. r
Penally ....................................... $
Pressure Reducer .......................... $
Meter Horn ... ........ ................. ....... $
Water Meter ................................. $
Sewer & WaterConneclion Fee ........... $
Water Tower Fee ........................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
GaS~ir.Plac P.~it ...................... $
Thi ion Seco es i1ding Permit When l1?r~dt:i
By _ /J Date 10/1/'f I
. I /
Certificate of Occup n
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7(,p 0 0
Paid -[ (p . r7J Rec.ipt No. ~ (, "2-- ., d
Issued
Oat. / IJ I. (-hi By /;J-tL--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdin~nce a may proceed al 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.
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850