HomeMy WebLinkAboutBuilding Permit 99-0288
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
"
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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SCHEDULED
DATE TIME
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52-'71 /40flf ~itr-l~
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o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
W 0 SEWER HOOKUP ^..... (t) 0 FIREPLACE FINAL
\fY ~ PLUMBING FINAL<!1fJ"@,' ~O GA~L,INE AIR TST
o MECH FINAL 1-/,_ 0
,
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CONTR.
PERMIT NO.
, (11/')01111
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o WORK SATISFACTORY, PROCEED '- '-~
~CORRECTACTIONANDPROCEED ~ ~, ~o~
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /2..., Owner/Contr: ~V
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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2~O~~ PRI~I( <'7.
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QATF R~ 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 . ~e5
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
5';). GC\ - \ 4- a+h S+ I\l e..
1, DATE
Ii- - ~ . qq
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT -.:2.. BLOCK
ADDITION ~..----pIM'~~
/ v ~
4. 0 ER (Name) (Addres
M,ch~ny LH'\&.A S'mN-h
ITECT (Name) (Address)
12, NO, OF STORIES
PID ~5-()(a(o -DO?" 0
\~.~
13, TYPE OF CONSTRUCTION
(Tel. No.)
lo b). 445~5()g;).
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
.-1
6. BUILDER
(Name)
(Address)
(Tel. No.)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK Fireplace CJ Septic CJ
New Construction CJ Alterations 1:\ _ Addition CJ
Chimney CJ Misc. .s ~ ",p.ro J,.J..Ur J.p .r
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
Sq, Ft. Width Depth
Deck CJ
Finish Attic CJ
Re-roofing CJ Porch CJ
Re-siding CJ Finish Basement CJ
SEATS
16. PROJECT COSTNALUE
1 0, CULVERT SIZE
Yes No
17. COMPLETION DATE
, hed information on this applica' n which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
nd that all construction will co orm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
pe']11it for jus ~,urth ereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x
License No,
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
CJ ENERGY DATA
CJ
USE OF BUILDWG
K~ Co,
Ii jR
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V ALUA TION
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
BUILDING DEPARTMENT VALUATION
()
SURVEY
PLOT PLAN
CJ COPIES
CJ
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A B E F HIM W S U
Division 1 2 (2)
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $ I, Q 50 . ()(')
'* nu\-e\ Collective Street Fee ....................... $
13oo.co L....H ~\. \o.e, fo.~ct Sewer Tap ...................................:
~t ~~ ~~ll ~ l:)\: . Pressure Reducer ..%~................. $
\ ~r\M.\ I. VIe r-e\MD.<..,':'1
Plumbing Permit Fee ....................... $ ~'OO'O6 wdA lae.. "'eterHom......~..II...................... $
M h ' I P 'tF $ ,"\ Water Meter ......e..................,;.......... $
ec amca erml ee ..................... 10 \ -ed<. C\J ~ t- c...... ~ .:;>~~
-f" Sewer & Water Connection Fee .'(lo~... $
Sewer & Water permi~t..... ................. $ '7 \.\e.'...... fl ~~ ,o1J a' W t T F $
1JA ;:) ~ VoJ r ~ I '" '1 aer ower ee ...........................
Gas Firepl P.e ." ........ ..... $ ~ 8io \ '^- he.s ~ Water Tap ................................... $
This App' ti r uilding Permit h ved. Builder's Deposit ............................ ~
By . -:filIIIe 9' Other ......................................... $
Certificate of Occupancy Total Due .............................. $ Ll.~
Paid 1..2.1...O.:::>-....J Receipt No. ~ ~ I
Issued Date 4- f.., (~c., By ~*
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ~ may proceed as requested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy. a Certificate of Occupancy must be issued.
Plan Check Fee ............................. $
~so
State Surcharge ............................. $
Penalty ....................................... $
LIS . ~O
\ ~ S .60
II ;2 (')(') .0 C)
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City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
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