HomeMy WebLinkAboutBuilding Permit 99-0115
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDWLED
/0 -/SJ79 A, 'li
ADDRESS /'17L.jLf ~ ~J T,Q",
o
OWNER
CONTR.
PERMIT NO. ?9- / / 5'
PHONE NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ()) 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
fiiit FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: 4-
(qnr1 k J~
8
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~-~:J
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W/J..K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: 811- ( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY'
INSNOTI
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
!
.221199
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITEADDRESS 141~~ .....-~ Y 1(,
1. DATE
J-Il-qq
3. LEGAL D1;~CTIPTION
LOT /-,
l
~. kl1r.g~
I ro J ,1
PID ~~ -,,-:)i q- 0 (4 -0
4. OWNeFl..t2 (~alre
(I)YlJ II. f.
5. ARCHITECT (Name)
I
1"1-
2-
~ J el(lfl,-t~ro!&1~.J{)~1
(Address) ~~
ADDITION
\......
6. BUILDER
(Name)
(Tel. No.)
(Address)
(~1.l1O.!iJ~n So~ltLl vI r. R'.roofi", 0 ~~tl~~13
New Construction c::J Alterations c::J Addition 0 Finish Attic c::J Re-siding ~ Finish Basement c::J
~
Chimney c::J Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
I hereby certify that I have fu
the above mentioned pro
. . revo
Yes
No
10. CULVERT SIZE
1. White
2. Pink
3. Yel10w
File
City
Applicant
nc; ;-
Permit No. -,. (-0 II J
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
OCCUPANT:::
SEATS
16. PROJECT COSo/ ALUE
~L4QZ).()J
17. COMPtETION DATE
x
".gYROPERTY DIMENSIONS
I fidth Depth
, .-
fo ,flalio nth' application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
a 111 c st Ion wi nform to all existing state a~s and will proceed in accordance with submitted plans. I am aware that the
i 0 . use. hermore, I hereby agree that the' . or a d~~ee.~y enter upon the property to perform n~ed inspections.
" .' Z:>Cth~ ,,;.<.-/7...y7'
g ~~~. ~
,- -"
- "'
MATERIAL FILED WITH APPLICATION
1/
SETBACKS: Req&ired
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
] PERMIT VALUATION
USE OF BUILDING
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS c::J SETS
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 tLl ,,5
Permit Fee ................................... $-
Plan Check Fee ............................. $-
Amount Brought Forward .................. c:
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
State Surcharge ............................. $
Penalty ....................................... $
J ' d-.5
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $.
Other ......................................... $
Total Due ...................RtJ.. ...... $ 7(P (' CO
Certificate of Occupancy ...., ~ '/ /?
Paid -;;"y . eceiptNo. '"') L/7/....,
Issued - .
Dated-};}-91 By ovLAJ
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 ~~~~ed. 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.
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
24 hour notice for all inspections 447-4230
Special Conditions n any
City Planner
Date
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