HomeMy WebLinkAboutBuilding Permit 99-1295
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULEO
(a. -'{)-''1 \
AOORESS
'1$11/ ~L.-;VN>
OWNER
CONTR.
PHONE NO.
PERMIT NO.
?CJ-J:} rs
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION _ -/L {];I,
)f FINAL ,Ml-p..<<P VY
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
o~
~ ./?JP
VORK SATISFACTORY, PROCEED
~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /flP-- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
L7
~~
.QAli FlFGFIVFn
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicanl
lo/ze/9C?j
Permit No.
q9./z~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
2. SITE ADDRESS
4-4 I I
3. LEGAL DESCRIPTION
LOT S BLOCK
tA~R.1 A6l:::-
c..HSSTf\..lUT
LANE
g./
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(H.ight) (Width) (Depth)
12. NO. OF STORIES
ADDITION
3
HI L.LS
PID 25-314-- 02..4-0
4T1t
13. TYPE OF CONSTRUCTION
4. OWNER
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel No.)
6. BUILDER
(Name)
(Address)
(T.I No.)
C-.1Z PAg-rgIDqt-, i4&Q(P LANDAU LN., PL..
t.fL+,- I E4b
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTP
7. TYPE OF WORK
New Construction [j
Fireplace 0
Alterations 0
Septic 0
Addition CI
Deck 0
Finish Attic 0
Ae-roofing 0 Porch [j
Re-Sidi~ Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney LI Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
x
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
ave 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
roP!'! n t all co ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
ke i e it r just e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
17. COMPLETION DATE
License No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
RE-S AIR
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: , II III 'V V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. It
Park Support Fee ........................... <t
SAC ......................................... $
Collective Street Fee ....................... <t
Sewer Tap ................................... <t
$
Division 1 2 3 4
Permit Fee ................................... $
7 +7'5"
Plan Check Fee ............................. $
State Surcharge ............................. $
(.2-S
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer ...........................It
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
:f!Ji:r.PI.~ 0::""11 r~~.jjJJ~;,~i~~.~..~it Wh.n ftP"'rqc.
By 'vL-'I:-za:cc D.t. /0 I q I
. I / I I
Certificate of Occu~ancy
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
7fo.VO
D.,. 'Q/~jtf 't 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 proce~s 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.
Paid
Receipt No.
"7&.00
3f.r.43Q
I
Issued
City Planner
Dale
Special Condi!ions ff any
24 hour notice for all inspections 447-9850