HomeMy WebLinkAboutBuilding Permit 99-1141
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
132E!3q
SCHEDUL.ED /r;j6./?'1
HIC-K.o.ev
I
.4.T
CONTR.
PERMIT NO.
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o PLUMBING RJ 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL /t'1)\ 0 GASLINE AIR TST
o MECH FINAL (~"j( A"OOj: j:"INI'/,--
~,;,.., (7~P~/
I V
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........
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. L SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO".. CALL FOR REINSPECTION BEFORE COVERING
Inspector: m- , Owner/Contr:
I
.cALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
Chimney 0 Misc.
/8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
r hereby certify that I have furnished infom,ation on this application which is to the bes, of my knowledge true and correct. I also certify thaI I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local taws and will proceed in accordance with submitted plans. I am aware that the
building official can rzke this pe.rm ;'Jl.or ju t cause. Furthermore, I hereby agree thaI the city official or a designee may enter upon the property to perform needed inspections.
X '4 ~ ' 1: . . s-~ _ 'i'-'I~:!1f
r {{/ Signa License NO. . Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Corrective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......... ......................... ....... $
Total Due .............................. $
Pa;d 7~. 00 Rece;p, No.
Da'e '/;/(./1'1 By .dkP ~
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 Is requested. This document when'
signed by the City Planner constitutes a temporary Certificate of ZOlling compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
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QA T~ R~r.~IV~1"}
CITY OF PRIOR LAKE
BUILDING PERMIT,
TeMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
9/1'?O/9!,
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. S'TE ADDRESS
,~~gq
1.CATE
Nt.-
1-JfJ-CJ1
,el
LOT
J. {I~ .JL...-<
~
PID .2.5 -072 - 020 - 0.
3. LEGAL DESCRIPTION
.s
7FTVS
i:l.lOCK
/ .s-r
ADDITION
4. OWNER (Name)
r,u:...u.w. v..- b IJ. AJ\4...-
5. ARCHITECT (Name)
(Address)
/.>. ~&''1..:....LJ..'IL-.u,
(Address) I
(Tel. No.)
~/J.-'Ns~"/) fi
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0 DeCk 0
Addition 0 Finish Attic 0
Re-roofjn~ Porch 0
Re-siding D Finish Basement 0
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Saok
Side
Side
BUILDING DEPARTMENT VALUATION
I
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
2 ">757.J. cIV
USE OF BUilDING
k:!l!:'.J .4/e-
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
7<.f."'~
Plan Check Fee ......................... .... $
State Surcharge ............................. $:
Penalty ....................................... $
I. ?J
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... .ft.
Sewer & Water Permit ...................... $
Gas Fireplace PermIt ....................... $-
Th;f!Id' . imeS.:MlY-l'lUlld;ng Penn;! Wp} .nAogroy<J".",
By w' /rrfiA...._ Date Y//-j / r ./
I ,
Certificate of Occupancy
ISSUed
City Planner
Date
Special Conditioos if any
24 hour notice for all inspections 447-9850
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
C/q' -//v I
BUILDING INFORMATION
11. SIZE OF STAUCT ~~~
(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. PROJECT COSTNALUE
17. COMPLETION OATE
MAT~HIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PILING lOGS CJ PERCOLATION TESTS 0
PLANS & SPECS 0
SUAVEY 0
SETS
COPIES
PLOT PLAN
Cl
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3'-2--/7