HomeMy WebLinkAboutBuilding Permit 99-1205
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING (f) 0 WATER HOOKUP
A INSULATION 0 SEWER HOOKUP
FINAL DEe'l... 0 PLUMBING FINAL
SITE INSPECTION 0 MECH FINAL
DATE TIME
l',-<;()
Qq -lacE
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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)( WORK SATISFACTORY, PROCEED
;;;' CORRECT ACTION AND PROCEED
o CORRECT WORK, CAll FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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nATF RFr:I="IVI=O
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
IO/I/qCj
Permit No.
QQ-/Z05
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
Ie:)t'l/I P,k~cl<. OC,r Ra
1. DATE
10/1/'19
R./5D
BUILDINllINFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
6
RASPBEI2f2 V
BLOCK
:2
I2ID6b
PID 25- 304- - 0/2.-0
ADDITION
/NQ
13. TYPE OF CONSTRUCTION
4. OWNER (Name) (Address)
,Tc.rYlE' 5 Tt'lhc. n f\e s
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
<Jo~ - 3'110
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction CI
Fireplace LJ
Alterations LJ
SepticLJ
Addition 0
DeckX
Finish Attic 0
Re-roofing 0 Porch 0
Re.siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT 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
:Uilding r:~c: ~h:'~for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perflo"7/e/~ons.
D - - fJ Signature license No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
Cl ENERGY DATA
Cl
USE OF BUILDING
RES Ale
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION ~.... -~,...,
PILING LOGS LJ PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
PLANS & SPECS 0
SETS
SURVEY Cl
PLOT PLAN 0
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................". or
SAC ......................................... It
Collective Street Fee ....................... or
Sewer Tap .,...,...,.,.,.,.,.,...,.,.,.,.,.,. $;
$
Division 1 2 3 4
Permit Fee ................................... $
R7.2">
6(".11
'2."0
Plan Check Fee ........ ..................... $
State Surcharge ............................. $
Penalty ............................,..."..... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..........,...,..",. $
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Pressure Reducer .......................... $
Meter Horn ... ,... ,... ,..,.."..,...,.,.,.",. or
Water Meter ...................,.,.......,... $
Sewer & WaterConneclion Fee ........... or
WaterTowerFee ........................... ot
Water Tap ................................... ~
Sewer & Water Permit ...................... $
Gas Fireplace Permit .............,......... $
This ~r JJJ..ao... Building Permit When Approv'!i
By , .~ Date /()-7~'C"
Certificate of OcZn; I
Builder's Deposit ..,...,...,.,.,.....,...,... ~
Other ......................................... It:
Total Due ............................... /4-5. '1t.,
Paid /4S-.f'- ReceiPt~...?t,,,/O '7
Data/~/99 By ~
This iS~' ~a ue~i e above application and accompany log documents is in accordance with the City zoni' ordi~ance and may proceecll"s requested. This document when
signed the. r con' s a temporary Certifi~te of ~~O~!liance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
..' t1/1 -I/r1q
Z City Planner Dale Special Conditions W any
24 hour notice for all inspections 447.9850
Issued
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White . Building
Canary . Engineering
Pink - Planning
The Crnlu of Ihe Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST:
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.c.~
Denied
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r $of(:nc.k ~ ok.
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Acceoted With Corrections
Accepted
Reviewed By:
)0-7 -crt
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION
RECORD
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DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS '\ ISOll -p,\~l: C)..~
TYPE OF WORK \)Qf\:"
USE OF BUILDING -5.FJ:)
PERMIT NO. '1, -/20S-
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BUILDER ~^\^o."'\'lJi!"'-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
PLACE NO CONCRETE UNTIL AB9V.: HAS BEEt- S GNED
, FRAMING I \). U'- I t1~1"\~'\
, FINAL I ~, I J?'M~
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Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
DATE ISSUED /0 - ~ -"'t"1
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