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HomeMy WebLinkAboutBuilding Permit 99-0275 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 'il, DATE TIME {o -I <( -?9 It.T ADDRESS J~S-'<;3 ~ ~~ eQ.. P/ OWNER CONTR. PHONE NO. PERMIT NO. 99 - C).. /~ o FOOTING 0 PLUMBING RI o FOUNDATION 0 MECH RI o FRAMING @) 0 WATER HOOKUP o INSULATION 0 SEWER HOOKUP )( FINAL 0 PLUMBING FINAL o SITE INSPECTION 0 MECH FINAL COMMENTS: 4 ' /J I(~ ~ I~ o EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o ~ ~ .. - pq ;2J'..1 ~~ --J / ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WO~ CALL FOR REINSPECTION BEFORE COVERING Inspector: e; -r ( Owner/Contr: I CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. INSNOTI 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. Yel10w File City Applicant NlRSIII Permit No. 99 - :lIS- . 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 I ct5.3?> 3. LEGAL DESCRIPTION l ft1~V1 1. DATE 4 J 5 J qq BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) LOT P>ref"j R+ BLOCK f 31:9 MdVl Rcl /'}~- /5~-OO I-a PIDO(V 12. NO. OF STORIES 13. TYPE OF CONSTRUCTION ADDITION 4. OW~ER _ 11 (Name) L\ n L\ ~ 5. ARCHITECT (Name) (Address) 1< (/\ S'IO C1 y f (c....- -, (Address) Li41~1j~{, (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE 6. BUILDER (Name) KfeuS{'y ~~n~ (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS Lj4~-3<6'1) OCCUPANTS 7. TYPE OF WORK New Construction 0 Fireplace 0 Alterations 0 '""Septic 0 Addition 0 Deck 0 Finish Attic 0 Re-roofing ~ 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 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 :uilding official can re~m.;!::-t ~ebY agree that the city Offici~;;etgg:e.;:y r~ Sn the property to pe;,sje,ns:,ections. , Signature License No. Date FOR ADMINISTRATIVE USE Front Back Side Side MATERIAL FILED WITH APPLICATION SOIL TESTS 0 ENERGY DATA 0 PILING LOGS 0 PERCOLATION TESTS 0 PLANS & SPECS 0 SETS SETBACKS: Required Actual BUILDING DEPARTMENT VALUATION TYPE OF CONSTRUCTION: I II III Occupancy Group A B E F):l 1 M Division 1 2(3.,/ Permit Fee ................................... $ /1_ IVG.Y ~S U OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION ~ SURVEY o COPIES USE OF B~ING /i J A PCpS' H//( .-; PLOT PLAN 0 City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ 7 (p!JZ--- 7 c.f.""D Plan Check Fee ............................. $_ State Surcharge ............................. $ ,.2~ Penalty ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Pressure Reducer .......................... $ Meter Hom .................... .... ........... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ Paid TOplJ..................~~~~i~;~O~ 3Cf8CJfj Date f{ - ')- Jj f By Sewer & Water Permit ...................... $ :: M" . .....I:;;,~,~;.;.:.~ '-. ~~ By ~~ * Date 'i "} - "'-+- Certificate of Occupan Issued 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 constnutes 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