HomeMy WebLinkAboutBuilding Permit 99-1292
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUI"ED
ADDRESS
3535
S~1A.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION . _.Ailf\
1'1 FINAL AA-;::::'""' ~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
o/{
DATE
TIME
iJ-t-7'1
9 '1-/ r5<r d-.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
c~~
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: M~ner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DATE RECFIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/ope,h'j
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
55'"3';
10
,t:.j
LOT
Z-
BLOCK 5: PID ?5-172-- 04:(,-0
su t.JS 6T .III '-'- S
-
ADDITION
4. OWNER
(Address)
(Name)
5. ARCHITECT
(Address)
, (... II".
(Name)
6. BUILDER (Name)
(Address) (Tel. No.)
/Z.OOrllVq 52G / OJ/IIII'! /NO ~ t-I/D
/J ~/
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alteratlons a
Deck 0
Finish Attic 0
Re-roofinQ)( Porch 0
Re-slding 0 Finish Basement 0
Septic 0
Addition D
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-/292.-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (DePlh)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. P OJECT COSTNALUE
7.00
17. COMPLETION DATE
I hereby certify that I have furnished Information on this application which is to the best of my knowledge true and correct. 1 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. 1 am aware that the
building 0 . . I can evoke is permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neljded ilJSpections.
X 20159~'ff /()~ &<1.
Signature License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... ........ ...... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water MeIer ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
other ......................................... $
Total Due .............................. $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Baok
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2S?5lJ. f/U
USE OF BUILDING
,2f::;- \ /f/;e.
,
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A 8 E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
7q.1S
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/.z....s
Mechanical Permit Fee ..................... $
Sewer & WalerPermlt ...................... $
Permi ....................... $
iklin ~:.';'It 1OilBrr/lfPl
I 7f r
Thi
B
MATERIAL PILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LI PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Paid
Receipt No.
-7&0&1
3(,.'111.---
Issued
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ina ce 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
24 hour notice for all inspections 447-9850
Special Conditions if any
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