HomeMy WebLinkAboutBuilding Permit 99-1248
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
12--/&_ 3~~~U1.
&~tjk{l, .3-#~.Q U~) ~
CONTR. JI..d~
SCHEDULED
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
KFINAL
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 GASLlNE AIR TST
o
COMMENTS:
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111"" WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~:t ;OR REINSPECTION BEFORE COVERING
Inspector: /---fM-- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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CITY OF PRIOR LAKe M )
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
QA T~ RFr.FtV~
I DIRECTIONS 11 DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN to \" 9 i
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) " _ {;"iIt \
12. SITE ADDRESS
f)l1fl...-.;r'""B 1<S\~It:-.,'/I~W ~~. elSD
3. LEGAL DESCRIPTION {/ c~U/11d U <..aU ~
LOT ~~ BLOCK PID Z'5-IS"f-Or2- 0
ADDITION
14~
15. ARCHITECT
6. BUILDER
(Name)
~y
(Name)
-
(Address)
\<:, '\0\ ~ /S>Jf;.
'\~;:7Mo
(Tel. No.)
(Address)
(Name)
(Address)
(Tel. No.)
-
~3- \~
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Cl?-/z ~~
BUILDING INFORMATION
~11. SIZE OF STRUCTURE
hJI "' (W;dthll ('loPlh,
"1.1 l (a v .)J-,
12. NO. OF STORIES \
13. TYPE OF CONSTRUCTION
~
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
SEATS
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing D Porch 0
New Construction 0 Alterations 0 Addi!i~ntL _ Finish Attic 0 Re-siding D Finish Basement 0 jt. PROJECT COSTNALUE
Ch;mney 0 Misc. ~ J(::b <O:st1.... ~. ~ L..oo . <;2.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLErlON D.ATE
Sq.FI. ~ Width Depth Yes No ~~ I 'Cf1
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am\he owner or authorized agent for
the above me,~~e::,pro~~~?l~~lt 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 officlarVvo~e b~or just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
SignaJre Ucense No. Date
Amount Brought Forward .................. It
Park Support Fee ........................... 4'
SAC ......................................... $
Collective Street Fee ....................... 4'
Sewer Tap ................................... <t.
$
Pressure Reducer .......................... <t.
Meter Horn ................ .... ............... 4'
Water Meter ................................. $
Sewer & Water Connection Fee ........... <t
Water Tower Fee ........................... 4'
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
/tEs h/L..
TYPE OF CONSTRUCTION: I II III IV (;;
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
PERMIT VALUATION
,'iN) .t'V"'l
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Sa)
2/.00
J !.{pS-
.5D
City:
Mechanical Permit Fee ..................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Water Tap ................................... 4'
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $~5.1!:}
Paid..35./~ R~ce'PI .::;;>t;..c//t::>
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Dale /0// ~ ./9
This IS to certify that the request In the above application and accompanylOg documents IS In accordance With the City ZOning. Ordinance and may proc.J as requested. This document when
S~t1lA C!tY I nerconstitutes a temporary Certificate of zonin~Pliance.J,pd allows c~ction to comlence. ~~. re.occu.p ~ale of acmust be issued.
. '-"' /r"""2.C- ~.... - ~)o;<..( t _ "'w.cJ i-1cttA<.
, I Planner - Date' ,. . Special Condillons if any - -
uilding Pennit rihen ~~,~
Dale /0-(
24 hour notice for all inspections 447.9850
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White - Building
Canary - Engineering
Pink . Planning
Tht (:tnlfr of tht L.kt Country
BUlI-DING PERMIT APPLlC.ATION DEPARTMENT CHECKLIST
NAME OF APPLICANT r?xt<.J. {)J~'1
APPLICATION RECEIVED 10 - I L - C]c;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
fY)C;JY'/(9'{ (2, 'Ii;lu~ VtClAJ 2~ Mh.
V
Accepted
Accepted With Corrections
Denied
~-{A..AP U~J_OrYL-'MJN'\_ Date:
to- 2-0,.qq
Reviewed By:
Comments:
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"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."
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