HomeMy WebLinkAboutBuilding Permit 99-0183
CITY Or;. PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
3"c);) .cry
AT
ADDRESS
:D07 J()sf fbrr-2Ctr7 CI..
OWNER
CONTR.
PHONE NO.
PERMIT NO.
91' - (<(3
o FOOTING
o FRAMING
~INSULAT)P.N
. FINAL /(R -;t.cQ
o OUNDATION ()
o DEMOLITION
o FIRE PREVo
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 LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
, ~
~ WORK SATISFACTORY, PROCEED
o ~ECT ACTION AND PROCEED
o CORREC!'rLL FOR REINSPECTION BEFORE COVERING
InspectorV)~/ ) Owner/Contr:
CAL-I~230 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
..
Permit No. C;i -1!J7
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1, DATE
2, S155&Q
LoSt- ~o~~
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
3, LEGAL DESCRIPTION
LOT S- BLOCK '2- PID ;<, S- - /~ S- - (")"2. <..( ~ 0
ADDITION ~ r~ ~Gd LGA
4, OWNSB,--- r'J (~e) /J A~ddreSS) /J /J/O (Tel. No,)
C~~ _V'/ v;"C;i!- ~,f}11.'YA~
5 -:j~TL, (N.mO)... I I A H- (A<jd....( (T,L No.)
/V\-- ~~~L("~)/~/Z19n.f:Jc.- L/L/O-5"",>~-&
6, BUILDE (Name) (Address) t. ~bNO,)
~ <C (2 Cjf-b -. fYI'ID
~t7;) f ~..uv r;S7)~!L(Iu:l12.lt...k't50..t/lu~~n. 59-120
7. T'fp OF WORK Fireplace CJ Septic CJ ~/ Deck CJ Re-roofin~ Porch CJ
New Construction CJ Alterations CJ Addition CJ Finish Attic CJ Re-siding CJ Finish Basement CJ
Chimney CJ Mise,
12, NO, OF STORIES
13, TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
8, PROPERTY AREA OR ACRES
Sq,Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17, COMPLETION DATE
I hereby certify that I have furnished 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 menf ed property and that all construe' !)-wi nf to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building officia a revoke th' . for just , ~lJl I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
License No.
Date
II
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
CJ ENERGY DATA
CJ
USE OF B~~ .
AIR..
I
TYPE OF CONSTRUCTION: I II III IV 0Q.
Occupancy Group A B E F HIM lR' S U
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
BUILDING DEPARTMENT VALUATION
PERMIT VALUATION
'~.soo.oo
SURVEY
PLOT PLAN
CJ
CJ
COPIES
City:
Amount Brought Forward .................. $ 7(p. OD
Park Support Fee ........................... ~__
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
7Y.7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
,. 2.~
.. p, ~~:;~;~.~.:. 7en ~9Wovfu
Date -~-U
71 I -
Certificate of Occupancy
Pressure Reducer .......................... $
Meter Horn ................................... iF
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... ll'.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Issued
Paid ~11 D~.~Q9.........~~~~i~~~~~ 3489
- - 1 \
Date ~-Ie-c;q By fM
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,
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850