HomeMy WebLinkAboutBuilding Permit 99-0209
Q~
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
IJ.-J-~~
5783 F~ Ct. S.F
SCHEDUlED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
?..1.::.;J 09
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION ~ 0 SEWER HOOKUP
Ji( FINAL ..u ~ 'i.V 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
- . /
or)
~~
')(.WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTJ
DATE R~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
.. 25.
Permit No.
er4 -d01
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
.5-9'i13
1. DATE
LOT
/ I BLOCK
() fLK l1i'oIje
/
(J 6LL r- j-
3-~~-1<7
;t15~
, PID dS -()f 3 - 61/-{)
/~r /lddn.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
FL /1-,1/ d R-A-u.- C0 S.C.
3. LEGAL DESCRIPTION
12. NO. OF STORIES
ADDITION
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
....fJtJ .b FL I J iii Ai
5. ARCHITECT ' (Name)
(Address)
:jJ,e.; oIL L~t..t.
(Address)
(Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
;n IV 'I tj () -(, ~,g9
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
t;tL L '-::...
7. TYPE OF WORK
New Construction 0
~~;I~~ ~
Alterations 0
~1211 A- A/
Septic 0 Deck d
Addition 0 Finish Attic 0
I]J4 1./~-C:<7~'L
. Re-roofing.R::'" Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
17. COMPLETION DATE
Width
Depth
Yes
No
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 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
bUil~fficial ca'}fevJ.!lll this permit for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~ r~ .-L':'.J/~C:;C)/3.S1g-L. 3-,;(S -99
Signature license No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING (1..1'-. 141 K. _
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 " III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
ill.iS
I \ ';}~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee .............._............ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ...._....................... $
Other ......................................... $
Total Due .............................. $ I G, .()()
710 .CX\ Receipt No. "3 If..~ t-S-
Date 3-}S-"14 By Q~
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 requesYJ. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cert~icate of Occupancy must be issued.
Paid
This Application Becomes Your Building Permit When Approved.
By Date
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850