HomeMy WebLinkAboutBuilding Permit 99-0193
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/6-Z2-" A,T,
ADDRESS
30(?'D
':;l~ ~,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
19 - / ~3
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS~R TST
Y v
~
----..
-~-~
~~
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
'-f FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
l~L( '-:
(d~
-.......-......
COMMENTS:
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR.i'CALL FOR REINSPECTION BEFORE COVERING
Inspector: kI":1- ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
QATE R~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.23.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRES~ # t '7fJ /I . P J }
3()~O ~I- f'Ctf '/(..-4 W,
..:1;;73/99
KI56
3. LEGAL DESCRIPTION
I?) BLOCK
F(). 7 rv/CIJJ &a {l 7
4.~R /! ~a.mJ! / /J (Address). '-/J I IJ (Tel. No.) i~ 1J...}
/--au,r /~ 3o~o ~U~~4tp, .y~t1-5~
5. ARCHITECT (Name) (Address) (Tel. No.)
LOT
PID ,-:is'" /3'1-()() 7 - 0
ADDITION
~m~
~ ~/~7Je. (tjl;)
1 ~t . ~"IG-7Kg /
- ./
7. TYPE OF WORK
New Construction 0
Re-roofing V" Porch 0
Re-siding 0 ' ~inish Basement 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
I. White
2. Pink
3_ Yellow
File
City
Applicant
Permit No. ~ '7 - I Cj ~
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
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
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 mentioned property d 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
:uildin . ial can revoke thO ~;:"ermore. I hereby agre.:5at)OtY7cR92.i~ee may enter upon the property to perfg ~~~t79ons.
Signature - - License No. ' Date" ~
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
COllective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ........................ ........... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid TWe ...................~~~~i~:~O~
Date 3-25-~7 By
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION Q/~(X)' C9- d
USE OF BUILDING ...
t:P'fo A I~
I
TYPE OF CONSTRUCTION: I II III IV (~
Occupancy Group A B E F -'"' l:\ I M""lU S U
Division 1 2 (V4
Permit Fee ................................... $ 71.{.; S'
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty......... ................ .............. $
I , '2.. S--
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
tE~:' ~~....... ;;::,~.;.:. Whm ""-"""- "-
_ _ _ Date '"""?~ 2~-'t /
............. -V '
Certificate of Occupa,Piy
Issued
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
o COPIES
PLOT PLAN
o
~/')
"1~. (/'"
J'lf8o '-f
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
24 hour notice for all inspections 447-9850
Special Conditions ff any