HomeMy WebLinkAboutBuilding Permit 99-0355
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SC.!:lEDULED
7-27,0 J
/l_T-
ADDRESS
SQ457//1861<- 7R-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq -.3st:)
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING rB 0 WATER HOOKUP
~ ] INSULATION 0 SEWER HOOKUP
~ FINAL ' 0 PLUMBI INAL
I] SITE INSPECTlO 0 ,ECH F L
COMMENTS: ~Or/5:1.
I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(~ (/1
,".":~
---JFJ",
~j{ ~
,."
/
)i WORK SATISFACTORY, PROCEED
/~ CORRECT ACTION AND PROCEED
:,:::ECT ~,OR REINS:::::':FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qC} ~ 3~~
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
~q'-l5 nMb/~r '1',(
1. DATE
'-IIILII'19
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
~. f=.
ADDITION
3. LEGAL DESCRIPTION
OJ
I
'IV OODLA-N 0
(Name)
(JRClA
12. NO. OF STORIES
LOT
BLOCK
2-
\-PIS .
PID 2..'.:, -C..:(__~ - 0 \5 - C)
13. TYPE OF CONSTRUCTION
4. OWNER
~f/ //
5. ARCHITECT
(Name)
(Address)
S~l{S {IMhfU' T~l,
(Address)
(Tel. No.)
l/'IO ..- al03
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~ { .eT~:S-e.t\
7. TYPE~OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc. W ,~_........:-
8. PROPERTY AREA OR ACRES
r- n_
<(t;..d
Septic 0
Addition 0
l~pc..tLl(LI-
Deck 0
Finish Attic 0
111/ AJ.
r;- 'I t. -{ 100
SEATS
16. PROJECT COSTNALUE
Re-roofing 1iC Porch 0
Re-sidingK Finish Basement 0
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
17. COMPLETION DATE
Sq.Ft.
Width
Depth
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 and thaI all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke th'J jermit for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to pertorm ne~d i'79tions.
X y ~ 41,~.. cV#~ 99'
. ~ture License No. r Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12- e=-s
f\/~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2."":::-. (J O.c/U
PLOT PLAN
o
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:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
'74, 7~
Plan Check Fee ............................. $
State Surcharge ............................. $
t. 2-~
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Certificate of Occupancy
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid '/ (., .00 Receipt No., 3~ 0 '2- ~
Date 4-//4-/qq By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinanbe a~ may proceed afrequested. This document when
signed by the City Planner const~utes a temporary Certificate of Zoning complianoe and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
7cP.()c)
This Application Becomes Your Building Permit When Approved.
By Date
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850