HomeMy WebLinkAboutBuilding Permit #99-0860
DATE TIME
CITY OF PRIOR LAKE A. 'G
INSPECTION NOTICE SCHEDULED to -/11-9'7
ADDRESS 5'"G 7/ iJ (J o.-~ S i.lJ E j!iJ.
,
OWNER CONTR.
PHONE NO. PERMIT NO. 1c; -~& 0
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING @ o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
~.
~/
;(M2/ ./.J-€ I
.
r"
~~
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
_."_._'~_____'__"."~m ___.. ___ .__~__________ _.~_..___ .__~_ ..__..., '._'..'_'.mu._._
~~
77~711
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
. ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
0l-Y(;O
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
1. DATE
3. LEGAL DESCRIPTION
5
O.A K.. VII 00 0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Deplh)
12. NO. OF STORIES
LOT
BLOCK
PID Z5"'O{{- fJOS'O
ADDITION
filL-v).
13. TYPE OF CONSTRUCTION
4. OWNER
C
(Name)
(Ad~
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Tel. No.)
m;k~
Fireplace 0
Alterations 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
6. BUILDER
(Name)
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
Deck 0
Finish Attic D
Re-roofinQ.iit'"" Porch 0
Re.sidlng 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 Q. CULVERT SIZE
17. COMPLETION DATE
Yes No
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 mentioned property and that all construction will conform to all existing state and local Jaws and will proceed in accordance with submitted plans. I am aware that the
building official c n revoke this permit for' st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perto':m}leeded in~ections.
X /-d-Yf
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
J<.~S" Fr/te
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
zs?5{), (f?./
TYPE OF CONSTIlUCTION: I II III IV V
Occupancy Group A B E F HIM R
DivisiOn 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
11.1S
Plan Check Fee ............................. $
State Surcharge ............................. $
/.2-(
Penalty ....................................... $
This
By
........ ............. $
n9 Permll W"'fl!rtft-1
Date I,
{
Pressure Reducer .......................... $
Meter Hom ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ..;,~.n.;................... $
Paid . U V Receipt No.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Date
'/1
Issued
By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni g Ordi nce and may procee as requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifica e of Occupancy must be issued.
City Planner
Dale
Special Conditions W any
24 hour notice for all inspections 447.9850