HomeMy WebLinkAboutBuilding Permit 99-0152
CITY-OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
'>-/9 - '1'r <t:OO
ADDRESS 141 01 N~~ Rd
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OWNER
PHONE NO.
o FOOTING
o FRAMING
~SULATION
FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: \AI 1hdAJ5
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CONTR.
PERMIT NO.
qq .../52
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHORE/WETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
";1',01
----
~
-.....
\
VWORK SATISFACTORY, PROCEED
, d CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL\ '.C OR REINSPECTION BEFORE COVERING
Inspector: ~ J \\ 4 Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
.81999
Permit No.
t;1-0/S"J.
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
3/3/qq
BUILDING INFORMATION
11 . SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS 14 I ~ I /) tLta1U R rmd
3. LEGAL DESCRIPTION
~
12. NO. OF STORIES
LOT
ADDITION --En..ud:u1<-;
4. OWNEIa 0Name)
'/'fUJJd rl/~
5. ARCHITECT (Name)
nlt1
6. BUILDER tt;(Name) (Add~ess.l
~aJ jbO-13rf:l rweruu/J0
OJ1df~ PvldJ'n ~
7. TYPE OF WORK Fireplace 0 S~ Deck 0 Re-roofing 0 Porch 0
New Construction ~ Alteration~ Addiijon 0 Finish Attic c? '" ~:-.:id~ng 0 Finish Basement 0
Chimney 0 Misc. fig .()1 (11'1 .J 8 I.dlnd n-UM Ln ......, W Tl U-/
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
BLOCK :;;..
~()V 4-#1 Adri..KJ-
(Address)
14/'tI7JafaJu M.
(Address)
PID 33- /dLl-(),1~-O
13. TYPE OF CONSTRUCTION
(Tel. No.)
440--7/;)1
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
95tn11
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PJjltJECT COSTNALUE
~ &! (.pS7'-
17. COLf7~/q~
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 mrlnti ed 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
b$''''~ ""! _"0' j , ~.. '"",_ro, I "'''''' "'_ "'" .. "" "l~. "qa de~ge! may enter upon the property to perform n~~ insp,ections.
x-J-ITX - cJm u.v~ q 3/C(C)
... - Signature' - License No. Date -
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
I) _
USE OF BUILDING ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
7'-/c 7e;-
t . JS-
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ...... ............................. $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Penalty ....................................... !l'
Plumbing Permit Fee ....................... <1:___
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ -
Total Due .............................. $ .7~<aJ
Certificate of Occupancy --7/_ <2d ~1'7c::1' -
Paid jfp"'} Receipt No. U'1 J.O
:i:: to certify that the request in the above application and accompanying documents is in accordance with the c~:;0~1~ and may pr::ed as ~~.~iS 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.
tltl1ed.
City Planner
Date
Special Conditions K any
24 hour notice for all inspections 447-9850