HomeMy WebLinkAboutBuilding Permit 99-0755
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUl,ED
ADDRESS
t1t7/ /~ 4...P
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION . _J(/))
if FINAL AP ~vl W
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
- '/'
(In
/~
~
1./
DATE
TIME
/~- 6-13
'1'1- 7.ss
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/1l6\
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
t. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Q'f-755
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 .
t?{?7/
/dYF"'A-~~~;:t
/:) /-14L
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Oopth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
2..3 BLOCK
P.e/Ote- .s OUn-j
4. OW~ (Name). . J (Address) .
. '-<~/A_ Y.6.;/d;~ _ h rtf87/
5. ARCHITECT c::J (Name) . (Address)
PID 25-{)(j- /()5-0
13. TYPE OF CONSTRUCTION
LOT
ADDITION
, (Tel. No.)
/ AdbA-'l./T
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name)
$t;Z~
7. TYPE OF WORK Fireplace LJ Septic 0
New Construction 0 Alterations 0 Addition 0
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Deck 0
Finish Attic 0
..--:. -!e-mofirlg9/ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES Ig. PROPERTY DIMENSIONS 1'0. 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
building OffiCi~O this permit for just ca.us"" Furth~ore.J'here~ agree that the city official or a design.ee may enter upon the property toyerfym needed inspections.
X t'l-::;',r" , ~ ,i/ ~ -d/A~ b//7 /9 <9
I Jf signature t L - license No. - / ,. / o{te I'
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
K.es ..q/~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2~ V I). cIV
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R S U
City;
Amount Brought Forward .................. $
ParkSupportFee ........................... $
SAC ......................................... ~
Collective Street Fee ....................... <I:
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
-Jt-/.7)
Plan Check Fee ............. ................ $-
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
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This
By
7~ . I.fV
Paid -1(, . (/7/ Receipt No. 355"2. c;-
Issued - Date fo//7 jqq 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 a!f'"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.
ermit .. .................... $
i1dlng ~:t';'tt 1;1i1ft;~
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ,It
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Sewer & Water Permit ...................... $
Total Due .............................. It
CilyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850