HomeMy WebLinkAboutBuilding Permit 99-0276
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUI.,ED
~?J
2.:00
ADDRESS 0fj~ 7 BOUO/N SI .
OWNER CONTR.
PHONE NO. PERMIT NO. Q1.Z70
o FOOTING o PLUMBING RI o EXC/GRAD/FILLING
o FRAMING o MECHANICAL o LKSHOREIWETLAND
o INSULATION o WATER HOOKUP o COMPLAINT
o FINAL o SEWER HOOKUP o SEPTIC FINAL
o FOUNDATION o SEPTIC INSTALL o FIREPLACE
o DEMOLITION o PLUMBING FINAL )( ~(DI,J~
o FIRE PREVo o SITE INSPECTION ~
COMMENTS: /{~-~ ~.
,~-I~"~ t: J ' v U
~ 4//0
r~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~W fALL FOR REINSPECTlON BEFORE COVERING
Inspector , Owner/Contr:
CALL -4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
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
~ 'fJ, b. 'J R ~ u d /10 C; I
3. LEGAL DESCRIPTION
LOT I BLOCK
ADDITION r ill feV"~ ectqe.
QATI= RI=r.I=IV~
4. OWNER
R.6 GC;z. b
5. ARCHITECT
(Name)
/)c:'>l/ C/2'1
(Name)
6. BUILDER
(Name)
Dc: 1 k:)LJ
7. TYPE OF WORK
New Construction 0
C/) f,.j ~ ,
Fireplace 0
Alterations 0
co
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
'115199
I'
N. E'.
I
. r A........,.
J':4l- tt().(/J/\- "
.. ~-'11-COIV
PID ...
(Address)
,91 h.1 C
(Address)
(Tel. No.)
4L1IJ -3 080
(Tel. No.)
(Address)
(Tel. No.)
<?;ttM<::-
lf. LI 0 ~ 3 (J~O
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-~g 0 Porch 0
Re-sidiny-\ Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq - 'Z.1 b
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 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
buildin official can re)!flke this'Reh"ljfJ~.l:all&e j;~more, I hereby agree that the city offici,al or a designee may enter upon the property to performfeeded inspections.
X ,{jJ' { ),~ dl1.V1--- 6LJ() If&> <6 '7 '-I L@;J q f
Signature . License No. Date I
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDIN~_
TYPE OF CONSTRU~ I II III IV (JI
Occupancy Group A ~ F HIM R
Division ci) 2 3 4
Permit Fee ................................... $
Plan Check Fee ................. ............ $
State Surcharge ............................. $
Penalty ....................................... $_
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
Back
Side
Side
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2, ~c;-O(). DO
S U
City:
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
1(., -00
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace pe~' ....................... $_
This Application e s Your Building Permit W,I'P!:l. ~~2t'i}1.
By Date ,., , "1
Certificate of occUncy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
pai~~..ii"q8i....~~~~i~:~0~ ~6i:t
Date LI.,.5,.t:j9 By 'J1
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. ~s 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.
Issued
City Planner
24 hour notice for all inspections 447-9850
Special Conditions ff any
Date