HomeMy WebLinkAboutBuilding Permit 99-0271
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
It)-IR-C}~
A,r;-
ADDRESS /.tf;? '? P
~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99 - do '11
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
)iJ FINAL 0 PLUMBING FINAL 0 G~ AIR TST
o SITE INSPECTION 0 MECH FINAL ~ .
,
COMMENTS: ~~ ~ ~~~
Of f
If -lr.-~
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r
~y
/1
~
~ORK 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 & SAFETYI
INSNOTI
. .___,..,. "_'_'m~'_"""'__'m_..__"__._____._____,__..__"_,,_.~.,.
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
APR 2 9J:)
Permit No.
91-;)7/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
4/2/rr
;Ju tJ
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
4~~~~ jN{lm(l-.
.J...rtUfI1A-S W -.J 8;GAR-
5. ARCHITECT (Name)
2,SI/iJ;1~S ~~ ~~ /)6
3. LEGAL DESCRIPTION
LOT f 5""' 1/ ~LOCK ;< PID :?5 -;;U 5~ - ()J c;-{)
ADDITION 5;{Yl d ft;; n-r p 4f11 Add.t-1 .
J'fj~;r.t>>~' No.) Jw:JlcJ
(Address) (Tel. No.)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
(Address) Il j . A \ ((Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
:IS" ~ ~ l"1-6t/.JIJ.-S-/~ ,) OCCUPANTS
Wct~~ ~fo r55~20J~~;< jf:!:-5J' ~ ~ SEATS
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
~~
Chimney 0 Misc.
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 fumished 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
:Uildi~thi~i r just caus~urthermore, I hereby agree that ~66q m~gi;rJ enter upon the property to perform W~~ions.
Signature License No. ' Date
FOR ADMINISTRATIVE USE
Front
Back
Side
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING hs /4/ K
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~~~~~~...1...~...~..~... $ 7I/~
I'd-~
City:
Amount Brought Forward .................. $
Park Support Fee ..................... ...... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Su rcharge ............................. $
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 ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ .
Paid T076:d?............~~~~i~;~0$ J~i;~i
Issued c; J/.. J
Date L/ - d ~ 1-{ By O/C.U...,/
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 re~sted. 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.
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850