HomeMy WebLinkAboutBuilding Permit 99-0153
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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A,t;
ADDRESS / S /1- 9
OWNER
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CONTR.
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99-/55
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ FINAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 0 MECH FINAL ~ ~
COMMENTS: ~ -4.- ~ ~
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOn CALL FOR REINSPECTlON BEFORE COVERING
Inspector: I~ Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
qfj rn )4DJ-
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
MAR 9 1999
Permit No.
QC;-/53
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITEj5rlLJ ()ak M t
3. LEGAL DEsgRIPTION ;;j
LOT ~ BLOCK
o eLK \brk\t. ((+
4rITr\(~ 1~
5. ARCHITECT (Name)
1. DATE
~~3-'W
BUILDING INFORMATION
11 . SIZE OF STRUCTURE
(Height) (Width) (Depth)
Ii r~/e-
PID d~-o~-o~~~ 0
12. NO. OF STORIES
ADDITION
Ir)-r AM(0.
~gess) {)11 j(11 idae (f.
(Address) oj
(Te4lj~,. 4LJ~~
(Tel. No.)
'~,. TYPr;.,~ONSTI1CTION +
~Mt '-lit,' (L' fmn
14. FLOOR ARE APPORTIONMENT USE
6.~L~R (Name)
JOY tJUNJ:tnC.
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
16. p~hm~Tl$bUE
17. COMPLETION DAT'b
3 - as;- ,9'
I hereby certifyihave fumished information on this application which is to the best of my kn. owledge true and correct. I also certify that I am the owner or authorized agent for
the above men property and that~Will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding official c k this permi fo s ermore, I hereby agree that the c~Di~~~ enter upon the property to perf:r;qlr~m'
Signature License No. ' Defe
Fireplace a
Alterations a
/ Dtal$ddn~YTYI4rtla~ _ Bitt .
~JoDmjntfanl mN. $Sll39-
Re-roofin9)( Porch a
Re-siding a Finish Basement a
~., i.~ 3Ylrffi1
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction a
Septic a
Addition a
Deck a
Finish Attic a
SEATS
7. TYPE OF WORK
9. PROPERTY DIMENSIONS
1 O. CULVERT SIZE
Width
Depth
Yes
No
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
a ENERGY DATA
a
BUILDING DEPARTMENT VALUATION
fl, r.
USE OF BUILDING ~S j}-~ K
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS a
PLANS & SPECS a
SURVEY a
PERCOLATION TESTS a
SETS
COPIES
PLOT PLAN
a
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. . .. .. .. .. .. .. . ... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
74~ 1~
Plan Check Fee ............................. $
State Surcharge............................. $
. -
/<d~
Penalty ....................................... $
Sewer & Water Permit ...................... $
:- Fire ;;;;.-::" ., ;.;....;;1it.,;"'~.a:1
B)J 3 ytKidDate .~''J--' -,-/
Pressure Reducer .......................... $
Meter Hom ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ....... .... ..... ................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ....'}........................ $
-71 0(.
Paid I fl? ~ ~ Receipt No.
Issued 'J JI.
This is to certify that the request in the above application and accompanying documents is in accordance with the c~:;on~~:~ ~d may pr::ed ~~~~~:"~hiS 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.
Mechanical Permit Fee ..................... $
Plumbing Permit Fee ....................... $
Certificate of Occupancy
/~ccClJ
3"4757
City Planner
Date
Special Conditions K any
24 hour notice for all inspections 447-9850