HomeMy WebLinkAboutBuilding Permit 99-0332
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEOUb.ED
M -( ~ i., It. r;-
ADDRESS /5'(73 7'~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
fi -CJ 532-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
la' FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRADfFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~.
~o-r ~ /~ d~
I
~-~
"""- -
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Z(RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ I , Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HQUR~ IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTl
QATE R~
4-1(~/q4
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2, Pink
3, Yellow
File
City
Applicant
Permit No. q q - 33 ?
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
1, DATE
I>} )7
~II~ L~
~- /S'-9;J
/J .. ,RIS()
rj(.c:;4 2/?~ -
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
ADDITION
4. OWNER
6
BLOCK
PID 2..5- 1&5- 0 '-1-2--0
5. ARCHITECT
(Name)
//'r/J>.L2:;b.P
(Name)
3
5 ffkN <=i 12.1 LA:
(Address)
Cot -&.....J /51?? (/6-'"" (~
(Address)
13, TYPE OF CONSTRUCTION
(Tel. No.)
'-I ~ ?-<??t79
(Tel. No,)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No,)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
/h ~/&
/lv)/~42~
D,B/J
frJo/t's 4;".;# /k lJ~o.
Re-roofing)jf Porch &"
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Chimney IJ 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 cons ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official9l-' ,...uk~erm~t for j e, rmore, I hereby agree that the city o~icial or a designee may enter upon the property to perform needed inspections.
X ~ ?<- ~Cb.t.: crs-9:> SI-/~ -79
./ Signature License No, Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS IJ ENERGY DATA IJ
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS IJ SETS
SURVEY 0 COPIES
PLOT PLAN IJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
r2..e-s Ale.-
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ------=z- ~ . c.ru
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
74- :75
Plan Check Fee ............................. ~
State Surcharge ............................. $
Penalty......... ......... ..................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
'.2-S-
Sewer & Water Permit ...................... $':
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $': WaterTap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $
By Date Other ......................................... $
Certificate of Occupancy Total Due .............................. $
Paid IG ,,01.:> Receipt No, ~ rue, 4--
Issued
Date 4f 1>/,r ~ By 1M-
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 r4ested. This document when
signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
7~.oO
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850