HomeMy WebLinkAboutBuilding Permit 99-0379
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
.56;<'0
SCHEDULED / a.. . 7 ~9 q
r~ s~ Y .s: r:.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
?9-379
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION A~fi'\
/5 FINAL I\.R ''''''''0 ~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
I
()/1'"
c~ fJ?
~ORK 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 & SAFETY!
INSNOTI
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
di1o. 00
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
QQ-37C}
. 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 .5loU
fQ('r- lawn Sh()r-fS> !vl
3. LEGAL DESCRIPTION
1. DATE
l-t- t - ~ ~
S.6~~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
2../
.
BLOCK
PID 2-5-031- 0 1\ - 0
ADDITION FA If2..LAW N $l-ft:HZES
4. OWNER (Name) (Address), (Tel. No.) I.t~l ~ 8411:1.
M{'\iJ~ BY"DC~-e,nbrou9h 610'2.0 fClW'\QW(l ShDreSTrI S.t.
5. ARCHITECT (Name) (Address) (Tel. No.)
13hYPE OF CONSTRUCTION
~G- rbof
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
8t'1o -
3<<1tOD
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
,tt'P(\ 11")(1 8-\ex1o(S
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
Septic 0
Addition 0
I~~~ J...Q.YC \f\a\A:,tria\ ~Vd
Re-roofingl;1l"'" Porch 0
Re-siding 0 Finish Basement 0
Deck 0
Finish Attic 0
SEATS
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
16'r-b35~S,T~SE
17. COMPLETION DATE
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 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
:uilding ~vo^~. Furthermore, I hereby agree that the Ci~OO;;JtS~ '6 enter upon the property to perform 4e:d~ in~qqns.
Signature License No. 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
Ee'5 Ale.
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z.suu.lJ{)
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
74-.75
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... ~
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permij Fee ..................... $
J. '2.5"
$
Pressure Reducer ..........................,.
Meter Horn ................................... ,.
Water Meter ................................. $
Issued
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other.................................. ....... $
Total Due .............................. $
Paid 7(, .00 Receipt ~o.
Date 4-//(~ /4'1 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina~ce and may proceed tl, requested. This document when
signed by the City Planner constijutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certnicate of Occupancy must be issued.
?fo.oo
3~4-1
Sewer & Water Permij ...................... $
Gas Fireplace Permij ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850