HomeMy WebLinkAboutBuilding Permit 99-0213
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/1-J8~
ADDRESS
&08J
1:S0 Ai 5f:
OWNER
CONTR.
PHONE NO.
PERMIT NO.
??-d./3
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TI~N...-e fiJ\
~ FINAL .....!An) U '(!J
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:
AVvv ~ - OX
g
("~ IJ2
-,{ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/iLeA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1125
J900 .
,
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
( QO~2
1. DATE
3);)Lllqq
f( lSb
PID ~'-111-DJ/--O
-
l-_
ADDITION
4. OWNER (Name)
'?---, ~ ,\ L ~Y"\cj..
5. ARCHITECT (Name)
(Address)
(Tel. No.)
L./ L/ (') . 'J .~;:J.,-'S
(Tel. No.)
(Address)
6. BUILDER (Name) (Address) (Tel. No.)
Irq/, Lav'L ~\v-~*\'Q\ ~\..0d
(~C\ r~" f 1.C- '" ~ -\: "\" ,...... L--- 'I Of') - C ~ ex":)
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofin~ Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc. /l J.-- ~ c:... ~v- tV'- 0\(' nl'-D..Cl P
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I. White
2. Pink
3. Yellow
File
Ci'y
Applicant
Permit No. qc, - "Z 13
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16.~O:ECT COSTNALUE
17~Et6a~ -
L( IdY {qq
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 the owner or authorized agent for
the above mention 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
:uildi~ial ca evokv~ust cause. Furthermore, I hereby agree that th:.:l (\Cit~ qe~n~ m~ enter upon the property to pe31'3.~~r99ions.
"1 Signature Licensil1'fo. D te
/1
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING I2t..s fi1k-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
SOIL TESTS
o ENERGY DATA
o
PIUNG LOGS 0
PLANS & SPECS 0
PERCOLATION TESTS 0
SETS
SURVEY 0
COPIES
PLOT PLAN
o
Plan Check Fee ............................. $
1L1'/~
,.d.6
Amount Brought Forward .................. $
Parl< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... ~
$
S U
City:
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid ~7~~OO""""""" ~~~~i~; ~o~ _-3?1'<?1~
~ ~)
Date .~ - 2544 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 proceed as req sled. This document when
signed by the City Planner conslttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Sewer & Water Permit ...................... $
Gas Fireplace Permtt ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ij any
24 hour notice for all inspections 447-9850