HomeMy WebLinkAboutBuilding Permit 99-0392
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED IJ.. -7 - 19
ADDRESS
1.{1'77,F~ ~
OWNER
CONTR.
PHONE NO,
PERMIT NO,
7 9-3 fj ,2
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING :dfJ 0 WATER HOOKUP
\S-INSULATIO~ . ~ 0 SEWER HOOKUP
P. FINAL Ao """'0 t 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
oA
/~ ..(..dP
'\..-wORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
/IUJ\
Inspector:
Owner/Contr:
C!ALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS A1!E FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
o 13
~~
.om ROr:= CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
Lj/;q /q 7
~/
PIDd5 - If 7 - ty./'/f-u
12. SITE ADDRESS
1&197
fj /Ith/)j/e., Aue
3. LEGAL DESCRIPTION .
LOT _ I BLOCK-</
AODITION Jj fW Ks (/; /1,0 ;/;1/ s
14. OWiPJ /1t1_lta"tk"T: h N
1c<lfA...
(Address)
(Tel. No.)
t:z/2..-#o-Z/ IS
(Tel. No.)
15. ARCHITECT
6. BUILDER
(Name)
(Address)
(Name)
(Address)
(Tel. No.)
Se~L..-F
7. TYPE OF WORK Fireplace (]
New Construction 0 Alterations 0
Re-ro~~ Porch (]
Re-SidingA Finish Basement (]
Septic (]
Addition (]
Deck (]
Finish Attic (]
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -3 qJ-
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
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certifY. I have furnished infonna~tjon n 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 '0 ad property and that all n ruetion will conform to all existing state and local laws and will proceed in accordance with submined plans. I am aware that the
building 0 . i c revoke Itf penn 51 use. Fytjhennore,) hereby agree that the city official or a designee may enter upon the property to perto~1;iections.
X /J f ..&.~ c; Ct
~Ignadlfe . License No. Oat . /
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLA liON TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION ;.1 c:::rY"). ('f) PLOT PLAN 0
SETBACKS: Required
Actual
Front
BUilDING DEPARTMENT VALUATION
USE OF BUILDING
-Ls
~IK...
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .................. ..................... $
17. COMPLETION DATE
S U
'lLJ, lC)'
I, At:)
Amount Brought Forward .................. $
Park Support Fee ........................... $:
SAC ......................................... $
Collective Street Fee ............. .... ...... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. <t
Sewer & Water Connection Fee ........... <t
Water Tower Fee ........................... $
Water Tap ................................... $
City:
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Builder's Deposit ............................ $
Other .......................... .... .... ....... $
Total Due .............................. < ~ 110. C()
Certificate of Occupancy -j I
Issued Paid I v;. r-,C) Receipl No. ::I, Sf) 'S:. 3
This is to certify that1l1e request in Ihe above application and accompanying documents is in accordance with the c~:;on~ ;,1i~:';n;maY pr~d as reqUe9d.~~s ~ument when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
This Application Becomes Your Building Permit When Approved.
By Date
City Planner
Special Conditions W any
Date
24 hour notice for all inspections 447-9850