HomeMy WebLinkAboutBuilding Permit 99-0285
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED ICJ-t?-?7 hT{;
;Z~~~
ADDRESS -'f) if; 9/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9q-~?,s
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
'lit- FINAL 0 PLUMBING FINAL 0 G~I~?AIR TST
/0' SITE INSPECTION ~~ A 0 MEC~N~L /, '" ~ . ~ I'
COMMENTS: i)CJ-t?-/ ..4l ~ /~ ~
/
c~..~~~
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~, Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
QATE R~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.S/S609EjS 1=Jrll "PoINT 1<oIJ-D
3. LEGAL DESCRIPTION
LOT
1
1f..1Df)6Af O/T-JCS J sT ADDAl.
.,pa$(JWNINf.. I r;:"9re~SiI1tJIIJ:r&b
(Name)
1. DATE
3/i)..')/19
j!../
/'1
BLOCK
PIO
25'-073-017-0
ADDITION
4. OWNER
:>olh-J
5. ARCHITECT
(Address)
(Tel. No.)
Lf 1.J7"'/ tIS'
(Tel. No.)
6~~~/e~;jm~/L.?:;1-1I6 1;;~7 NicfJJJ.rr A-r>iTSNO.)
Ct:J~t9t.rdR$ ,.:!:Nl...,BU/!.NSdIUt. mtJ
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing}f Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq.Ft.
Width
Yes
Depth
No
I. White
2. Pink
'~ob~2:{)r7 Yellow
Permit No. 99- 2as-
File
City
Applicant
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
~h y cert. ify th 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
above menti ed property and t at a construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
ui. IC. can rev e this t f use urthermore, I hereby agree that the city Offi~O ~ de;;# lflnter upon the property to perfoi7~drNec1ons.
nature License No. ~ Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
1265 A/~
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
~ L/-. '7 S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.~~
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
~iS APPli~i1ding ~:;:it Whe;;/11~1
Certificate of Occupancy
Issued
Side
2000. cTD
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................ ................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid .:.J /, /? 1 Receipt No.
'f/,/f?
7(,. 00
:3'4((P .7
Date
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.
By
City Planner
Date
24 hour notice for all inspections 447-9850
Special Conditions if any