HomeMy WebLinkAboutBuilding Permit 99-0416
nO DATE TIME
CITY OF PRIOR LAKE /J.-J-?1
INSPECTION NOTICE SCHEDUL,"P
ADDRESS .<;(30 L .~'" M.
OWNER CONTR.
PHONE NO. PERMIT NO. '1'1-'1/1
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULA~~ o SEWER HOOKUP o FIREPLACE FINAL
)I!. FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
oJ"
.
/~ P
il(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/fvCA.
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
3~1
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
APR 23 1999 ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~-
1 White
2 Pink
3. Yellow
File
City
Applicant
Permit No. q Cf -4- ( G?
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
IZ. SITE ADDRSft> 30 L-uTttBT2.. I2-D.
3. LEGAL DESCRIPTION
LOT
BLOCK
ADDITION
140 OWNER \.
15. ARCHITECT
6. BUILDER
1. DATE
:{- d-3 -'17'
-e-IS,D
BUILDING INFORMA TJON
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID .25- Oz.-.r - no I -0
) (Name) _ (Address)
I fV\ TQEC &12--0
(Tel. No.)
13. TYPE OF CONSTRUCTION
~-r~-
14. FLOOR AREA APPORTIONMENT USE
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
rtify at I have fumlshed 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
m oned property a that aU construction will conform to all existing state and local laws and will proceed in accordance with submitted pla~s. I am aware that the
ff revoke J,hl i' st cause. FurthermorE}, I hereby agree th:5e 0 Oib a ~~al::}nWjpon the property to p;opfi n:..etf..~r:.ect~'1
S~"t""'1 ~ ,,"'''', No. 0",
(Name)
(Name)
yY)O I~ 15l/ I L-P E J2-S
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations [j
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES
Sq. Ft.
I hereb
the
din
---
1.-/
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~ Pc- / FtC-.
I
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ............. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
(Address)
(Tel. No.)
(Address)
653D
.13S-r~
t/t/7i!."' Nt) 0'-'5:
s::rvJ ~vlA ~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Septic 0
Addition [j
Re-roofing'X" Porch [j
Re-siding 0 ./ ~ish Basement 0
Deck 0
Finish Attic [j
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 2- ">V() ,cf(..I PLOT PLAN 0
City'
Amount Brought Forward .................. $
Park Support Fee .... ....................... <I'
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
I t.f. 7~
,.z-r
Pressure Reducer .......................... ct
Meter Horn ... .... .... ........................ ct
Water Meter ................................. <I'
Sewer & Water Connection Fee ........... <I'
WaterTowerFee ........................... $
Water Tap ................................... <1'.
Builder's Deposit ............................ 4'
Other ...................... ................... $
This Application Becomes Your Building Permit When Approved.
By Dare
Total Due .............................. <I:.
Paid il,;, .00
Date 1t/Z/7/Cj~ By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinarke and may proceed as 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.
-L fR.()CI
Receipt No, ~ ...-z:, I I
fjff-
Certificate of Occupancy
Issued
CityPlannef
Date
Spec~1 Condrtions if any
24 hour notice for all inspections 447-9850