HomeMy WebLinkAboutBuilding Permit 99-0341
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED /tJ~/J'-9t A. v-:
':;:2~ ~ $,
ADDRESS / 5 ~ 5...5
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ9- 3~/
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
lCFINAL 0 PLUMBING FINAL
rD~ SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ -/ O-d
I tJ
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA~R TST
Jr ,
~~
c{~~ ?~
-
~K 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 & SAFETYl
INSNOTl
~CEIVED
4-/ f3/qq
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.
qq- 341
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMiT is ISSUED (Please Print or Type and sign at bottom)
1)7;3/99
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADD!l~S
/5~53
3. LEGAL DESCRIPTION
I
AMGl\!
~/RcI~~~
,
I
I s-r AODtJ.
LOT
BLOCK
ADDITION
MeES
~.~
5. ARCHITECT (Name)
12. NO. OF STORIES
PID
').5- I8'O-06/-D
13. TYPE OF CONSTRUCTION
15ij7i3 ~~J})Ni}q7 _ R J~~' FLOOR AREA APPORTIONMENT USE
(Address) (Tel. No.)
6.~}D~R..l.-H ((t\N'''lII').J- < >/7~"~~.J... /'},~.
~0~ .y3tp~' ~?YI;r>
~ 7'-rWU
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
-'I'I!}~ 7 Rt? I
"
Re-roofing)(" Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Septic 0
Addition 0
Deck 0
Finish Attic 0
9. PROPERTY DiMENSIONS
Width Depth
17. COMPLETION DATE
10. CULVERT SIZE
Yes No
I hereby certify that I have furnished 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 an 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
buil~1 ;a~ revoke this . for just ca e. Fu e ore, I hereby agree that the city olficial or a design~ may enter upon the property to perform nfJ8f)e'J inspE!Jtions. _,
x~n. -t ~ B()o'7)Sq9,~ 'Y/13/9~
./ . Signature License No. Date '
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
EES A/l2-
I
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2-=- u U . em
PLOT PLAN
o
Division 1 2 3 4
TYPE OF CONSTRUCTION: I " III IV V
Occupancy Group A B E F HIM R S U
74-:75
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
I . 2. c:;-
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Gas Fireplace Perm~ ....................... ~.
This Application Becomes Your Building Permit When Approved.
By Date
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850