HomeMy WebLinkAboutBuilding Permit 99-1238
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CITY OF PRIOR LAKE
INSPECTION NQTICE
,
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
.!VNSULATION @
~~INAL ,eoOF n-
O SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
qq-/z..36
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ~/~ /'>~~ .-/
('Yj.k~ j7~ d.o " -
/'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~CALL FOR REINSPECTION BEFORE COVERING
Inspector: -.t2f: { Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
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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
City
Applicant
Permit No.
q c; - 1238
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
.(
1. DATE
10(13/'"
Ie/SO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
/'7/5775S I'PJp bOVNOS
PID 2..5-4.30 -/)313-tJ
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
14. FLOOR AREA APPORTIONMENT USE
6. BUilDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
PorchLl
Finish Basement 0
SEATS
18. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin cial can revoke this p 0 just c se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X" UcenseNo. /1!J//~t'P
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPliCATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
,eES ...p'L.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS Ll
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS D
SURVEY 0
SETS
COPIES
ZS?J7J ~ rn/
PLOT PLAN
o
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 ................................... $
7~7r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
/.Zr
Plumbing Pennil Fee ....................... $
Mechanical Penni! Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & WalerConnection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......... .... .... ................. ....... $
Total Due .............................. $
Paid
7(,.cJ 0
(
Sewer & Water Permit ...................... $
This
By
Issued
Date
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 commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Date
Special Conditions H any
24 hour notice for all inspections 447-9850