HomeMy WebLinkAboutBuilding Permit 99-0382
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/L/SZO
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
]i( FINAL ~JK1i)
o SITE INSPECTION'\.JI
DATE TIME
SCHEDULED
1/" 9,4 'iq
s~ L/h /I.t;.
CONTR.
PERMIT NO.
?7-38J..
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 GASLlNE AIR TST
o
COMMENTS:
ro~~\
~nJ) ~~
)(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/t~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
APR I..
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 /4
5.30 -.:5u ,eegy LAAJE:"
/
relCJI2-. LA~-
I
3, LEGAL DESCRIPTION
LOT
9
BLOCK 2-
c.,(},(? K...I t:}bE II'LLS - 77It/2D
~wD,rIO,.J
ADDITION
4, OWNER (Name)
JOt/AI ZaWLDclltL/
(Address)
-5:4HE,C}..s ,C}L9DI/t::=-
(Address)
5, ARCHITECT
(Name)
DWA./ &=..-fl..-
(Name)
DM/A//::;~
(Address)
6, BUILDER
7, TYPE OF WORK
New Construction 0
Fireplace 0 Septic 0 Dec~
Alterations 0 Addition 0 Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
Chimney 0 Mise,
8, PROPERTY AREA OR ACRES
Sq, Fl. /0/09:;-
9. PROPERTY DIMENSIONS
Width 80; Depth /25 I
10. CULVERT SIZE
Yes No
1. White
2. Pink
3, Yellow
File
City
Applicant
Permit No.
qq,3g2-
1, DATE
12 tiP,€, ? Cj
BUILDING INFORMATION
11 , SIZE OF STRUCTURE
(Height) l' (Width) /51 (Depth) /(0 1
12, NO, OF STORIES
/
(Tel, No,)
447-770S-
(Tel. No,)
13. TYPE OF CONSTRUCTION
..DELL
14, FLOOR AREA APPORTIONMENT USE
240 .5;;;. Fr.
(Tel. No,)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJECT COSTNALUE
$/400,00
17, COMPLETION DATE
.30 1"'1"''1 c;'1 -
I hereby certify that I have fumished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the
building officia,I can revoke this pennit for just cause, Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn n~.,~nspections,
X _D ~ . 4/12/ t;?
__- '~'... Signature License No. / ,,' Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ -,j _. lli
Total Due .............................. $ I W
Paid ,/(,./9 Receipt No, 350(;, '3
Issued
Date 4--/zz,/4q By 4
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning O'rdinan~ and may proceed rA requested, This document when
Sig~PI ner consmute: a temporary Certifi~ ~ compliance and Iiows 0 stru '0 to comme ce, Before cupancy, a Certificat~cupancy must be issued,
~ . ... - 4 0 S . Ie ." ,
ily lanner ate peela 0 It ns" any
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
1/100.00
USE OF BUILDING I
fI.p~. )4 I/?
/
"
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A B E F J;. I M ~ S U
. ~ivision 1 2 Q)4 S
Permit Fee ................................... $ L1S'."7
City:
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
2lJ .7Cf
l/O
Sewer & Water Pennit ...................... $
~
Gas Fireplace Pe e~~~~.~..d.~it When Aj2projeg..
By _ "/ ~Ing ~:tr;: ~/cr-7~
Certificate of Occupancy
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
o COPIES
PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
24 hour notice for all inspections 447-9850
T
q9,-3~~
White - Building
Canary - Engineering
Pink - Planning
Tht' ('rnlpr of .he Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
H ;' J;7- - \
C' 'f:"_, \
APPLICATION RECEIVED
, ~
! { , .' ,;" I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ,'.~""
\ '
" '.
Accepted
~
Accepted With Corrections
Denied
Reviewed By: ~/ ~~ ,W~
Comments: '
1~1 ~;J~~ f~.~_
{1/'ttJV <:\0 ~. \(/.f)C..cAA~~
Date:
Lt / 2>> -c;S
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
T
..
1
'-1
1
J
)"; ...'. \,";
-~
1
l
"I
,
,
j
~. "
I-