HomeMy WebLinkAboutBuilding Permit 99-0090
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
s -t'CJol
SCHEDULED JJ.-J,99
~u;.3 S7f.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-0090
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~
;1lJ FINAL
o SITE INSPECTI N
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:
/1tDAY ~ {}- ~
~ f'4
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:
M
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
DATE REG.E!YEQ CITY OF PRIOR LAKE
--J B. -1F 3 3 7~ BUILDING PERMIT,
..J () . TEMPORARY CERTIFICATE OF
# 7~ (}j; ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/;l-tj- '1g
~UO
PIDd,')- J3t{-D/j-Q
(Address) A
~/lg 5/11! Ihnd /TIv-L 5
//1p~ m.,J S-S-~OC?
Septic 0 Deck 0 Re-roofing)( Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE 5bS~ ;;;....
C e dal'"' wood
Sf.
3. LEGAL DESCRIPTION
LOT 13 BLOCK . I
ADDITION.51w1 (JOI II\..t-e. S~ AMII\
4. WINER J . (tjame) .
K~ay SDderl, nJ f
5. ARCHIT~CT (Name) /
(Add res,s) /
5 hCf:;l.. Cedar-woDd Sf
(Address)
6. BUILDER (Name)
f/ t:Vn4Z./e rll {I () / /11 AJ
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
1. DATE
(Tel. No.)
L/~5-7250
(Tel. No.)
(Tel. No.)
?~/- &(/:J,8'
Yes
10. CULVERT SIZE
No
Width
Depth
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -60QD
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
16. PROJECT COSTNALUE
50;;;2. gr, ~o
17. COMPLETION DATE ?
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 laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke this e~it for,fst cause. Furthermore. I hereby agree that the city official or a designee may enter ~on the property to perform needed inspections.
-1( lb ~ .;2/77 12-~- 9J>
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V!QUATION
USE OF BUILDING
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 ................................... $
"14.15
Plan Check Fee ............................. $
State Surcharge .............,............... $
Penalty. ............. ................ ......... $
Plumbing Permit Fee ....................... $
\,zS
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
~ertificate of Occupancy
Issued
Side
~c;oo. -
- -
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City Pianner
Date
24 hour notice for all inspections 447-9850
Special Conditions ~ any
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid TOz~o/i4.........~~~~i~~~0~
, .. f
Date
7k
~o
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 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.
By