HomeMy WebLinkAboutBuilding Permit 99-0403
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/o-a-'71
A,f'
ADDRESS
L/L/P'I (1~~ J~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
E: FINAL
o SITE INSPECTION
99 -03
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
tf ~ (K)
C'/~-~
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
Jt~
,
~
COMMENTS:
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: a - Owner/Contr:
;
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
-~._~------,-. ^- - -.--.,-----..."
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DAn; I=IF~I=IVJ;I)
4/2-1 /q~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
2. Pink
3 Yellow
File
City
Applicant
QQ-403
Permit No.
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SIT~ ApDRESS
"I4<g~ e.H6sr Nur LN,
Chimney 0 Misc._
/8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished information on this application which is 10 the best of my knowledge true and correct. J also certify that I am the owner or authorized agent for
the aOO lioned property a nstruction will conform 10 all existing state and Jocallaws and will proceed in accordance with submitted plans. I am aware that the
build" 9 afficia can revoke thi armit r just use. Furthermore, t hereby agree that the city official or a designee may enter upon the property to perlol1]>needed in~ections.
X I . .~9Qq ''',-J'i-8t't
Date
3. LEGAL DESCRIPTION
~
LOT
BLOCK
ADDITION ('~L-~E:
4. OWNER (Name)
RoA f"e.'H-Pr'
5. ARCHITECT (Name)
6. BUILDER
(Name)
Rl(~.t+ T"lAJ I't-J
7. TYPE OF WORK
New Construction 0
RcoFI:Vt.,-
Fireplace 0
Alterations 0
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
---.e e-s / A e.-
e
1. DATE
1- /9.Q'1
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
L
\.h u-S
12. NO. OF STORIES
PID 2.S~ 3\4- -0111 . ()
4- "Pt
13. TYPE OF CONSTRUCTION
Re -12.-C:>g.:::
14. FLOOR AREA APPORTIONMENT USE
(Address)
S"C,""r
(Address)
(Tel. No.)
44~~ 4~ I
(Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
/200[;. 7 'It!:- ,4Ve.
gS-3-oo<l 'I
OCCUPANTS
Septic 0
Addition 0
SEATS
Deck 0
Finish Attic 0
Re-roofing't... Porch LJ
Ae-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
~z..I,
17. COMPLETION DATE
license No
FOR ADMINISTRATIVE USE
Bad<
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
COPIES
SURVEY 0
2- CJ v. o-v
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
ON;'''" 1 2 3 4 /4.,C;--
Permit Fee ................................... $
Plan Check Fee ................. ............ $
Slate Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
City:
Amount Brought Forward .................. $
Park Support Fee ............. .... .... ...... $
SAC ......................................... $
Collective Street Fee ......... .... .... ...... $
Sewer Tap ................................... $
$
I. Z. ..---
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
This Application Becomes Your Building Permit When Approved.
By Date
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid '7c.. ~
Date d-/l-l /411 By AJ,t---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning drdinance andlmay proceed a/requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Certificate of Occupancy
Issued
city Planner
Receipt No.
7'.00
~c:-oC#
Date
Special Conditions it any
24 hour notice for all inspections 447-9850