HomeMy WebLinkAboutBuilding Permit 99-0017
1: IS
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULE;.D
ADDRESS
3'17 B
s~ 1:A-
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION Af)
;xr FINAL A.L ~ (.!Y
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
();T
r..t?~ L-f
v
DATE
TIME
fJ...6.q~
? 9- 00/7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
(Address) ;, ( .z.....jTel. No.)
tfr~lr~~e~ i?'L f'b~ -~ /-.17
7, TYPE OF WORK Fireplace Ll Septic Ll Deck Ll Re-roofint Porch Ll
New Construction Ll Alterations Ll Addition Ll Finish Attic Ll Re-siding Ll Finish Basement Ll 16. PROJ~ COSTN~E
Chimney Ll Mise, rC-A-r { / 7 a / cn;;-
:~~:~PERTY AREA OR ACRES :i::OPERTY DI~:p~:IONS ~~'sCULVERTN~IZE 17'?!fgO/S, ~
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 pro~e and th~t all onstructio~,will conform to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the
bUildin~al can revok ermit fo st ca~rmore, I hereby agree that the,c.!)iY official or a d~ignee may enter upon the property to. 96 rform n~eded i~,
X . ~{ iI1 t'&~_ /r'7C ~ /~ -T./
, ~ ~ Signature r License No. . Date (
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE q
(~S"f (
II" <sW
f-l"7C
PID ~ <; - oct6' -Cbo<:) --0
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITEADDRES~ t/ 7 ~ :J f'N~'" e
3, LEGAL DESCRIPTION /
LOT
t:::) BLOCK
ml1P~ ~ &V\"}
C <: J4~me) /J /,.. (Addres, ~
7 t, d f'..t&/y /t: h.) /If. l. /l. p~
(Name)l (Address)
(Tel. No.)
ADDITION
4, OWNER
(Tel. No.)
5. ARCHITECT
6. BUILDER (Name)
Of} /h;-A>>L
L White
2, Pink
3. Yellow
File
City
Applicant
Permit No.
1qrC~)17
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
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $'
SAC ......................................... ~
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Z-po, "V
USE OF BUILDING
/,1/4
f'-C-' ~,
,
AI#!-
/
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Permit Fee ................................... $
'1 4.7t:;
Plan Check Fee ............................. $
i. L-)
State Surcharge ............................. $
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS Ll
SURVEY Ll
SETS
COPIES
PLOT PLAN
Ll
Penalty ....................................... $
Plumbing Permit Fee ....................... $'_u
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water perm. it if;;...... ..........~.... $
Gas Fire~1 P .... .........':">.. $ - I
This App tio ur uilding Permit Whe7? 4~e/. 9 ~
By . ~ata .~
Certificate of Occupancy
Water Tap ................................... $.
Builder's Deposit ............................ $
Other ......................................... $
7r ('<b
Total Due .............................. $ \c .
Paid 7.fp. l.>1.l Receipt No. 34- 3 \ 0
Date \ f 0::;/11 By (?-,~ ~ ~M
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinanc~ and may proceed 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 Certificate of Occupancy must be issued,
Issued
24 hour notice for all inspections 447-9850
Special Conditions W any
City Planner
Date