HomeMy WebLinkAboutBuilding Permit 99-0171
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
S.Ch~DU\.ED
iJ:t.R'-c;2-
A./7"
OWNER
/43;1../ ~tf ~.LJM.:f-
CONTR.
PERMIT NO. q Cj - .12/
ADDRESS
PHONE NO.
~
~
o EX/GRADfFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
,.~
.d/J7LL- '
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
~~::::~::O~
~~
~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/
- ~RK SATI:FACTORY, PROCE~D
o CORRECT ACTION AND PROCEED
o CORRECT WOR'-1ALL FOR REINSPECTION BEFORE COVERING
Inspector: @:r, ' owner/Contr: -
/
CALL ~7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
-----
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
III ~..
Permit No.
q9-/71
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
-
~~77s/q9
I
N \=-_ ((tStJ
PID J5 -oqs: 1513-()
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS
ILl ~ ~, .Shrlf'Jl1 ~,n (' h~o...\ \
3. LEGAL DESCRIPTION
to
~rhl
12. NO, OF STORIES
LOT
.,.9L. OCK
~a. r:tt
13. TYPE OF CONSTRUCTION
ADDITION
4, OWNER (Name)
Lcl....{l~ _~{l ~'A \-z ~_
5. ARCHITEbT (Name)
(Address)
(Tel. No.)
yq~ -3D \ ()
(Tel. No,)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6, BUILDER
(Name)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
(Address)
\Iq \ '1 L.cvL~dv--~lQ \ b \ Jcl
0()tQYY\IJ; I r:.', ~...~~.\. ~,-. lie)!'") -a/CD
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofin~ Porch 0
New Construction 0 ~ Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PJ}OJECT COSTNALUE
ChimneyO Mise, . ~ l.A-L- J.r.-, c....,~rYY\. nlo,(V"\o..t2t t' .:tP/;;2., DC::D-
8, PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE ~7J' CJO,!~J~O~ DATE
Sq. Ft. Width Depth Yes No '- --J 1--'
I hereby certify that I have fumished infonnation on this application which is to the best of my knowledge true and correct. I also certify fhatl am the owner or authorized agent for
the above m?]tntiO ed prrrty 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)'lficial c revo this pennit for just cause. Furthermore, I hereby agree that the cily official or a designee may enter upon the property to pert07 need~ inspections.
X (A ""'" --L------' r9 0 \ .::)C] ') O?; 3LLS I qCj
I Signature License No. 'Date
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
!tjJfj/
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
Pennit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
{e(. f<<)
/.2e;-
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Certificate of Occupancy Total Due .............................. $ 7~.aJ
Paid ~ ' C)t:/ Receipt No. :5 t.('7--;t;'""
Issued
This is to certify that the request in the above application and accompanying documents is in accordance with the C~:;oning~r~:c- f~ pr:~d as reque2 ~ent when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued,
Mechanical Pennit Fee ..................... $
Plumbing Pennit Fee ....................... $
I
City Planner
Date
Special Conditions K any
24 hour notice for all inspections 447-9850