HomeMy WebLinkAboutBuilding Permit 99-0419
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUloED
/(J-/1-'19
A.0
ADDRESS
/5tJ3? A~ ~ "?/d.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q9- ~/9
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
/6 SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ k
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
~~
~~
I
~~
( (~
""'"
:rJL :>..
~
~RKSATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~LL FOR REINSPECTION BEFORE COVERING
Inspector: (0 1-, Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
.,
s~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
i1b.cx>
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.J]g- 4-(tL
.
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
J5()~?J G:jV1'"P'" Oct.\<.,<:...,
3. LEGAL DESCRIPTION
2.0
EtREF..N
1. DATE
t.h9,O ~qq
\2. ISO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
()AIC:.5
PID 33'175. 0'2-0'0
ADDITION
13. TYPE OF CONSTRUCTION
r2..E- - t2..C() l=
140W2~n
15. ARCHITECT
6. BUILDER
(Name)
~\ J lCln~nr\
(Name)
(Address) (Tel. No.)
/503Q Ellr(€.() CC1J<.-S
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Tel. No.)
" 3CJO'~OD
tlpn:f.1?(\ f)(-kx"\DY~ 1?n3 Larc..lrx*. e,IVd P;yi11e_ .,,):"53~:J,f
7. TYPE OF WORK Fireplace a Septic a Deck a Re-roofing)!(. Porch a
New Construction a Alterations a Addition Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc. I~II (\fill '-t . rAO\
8. PROPERTY AREA OR ACRES 19. PROPERTY DIME~NSioNS . 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify thaI I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding official can ~~~.:~/urthermore, I hereby agree Z};3l8i1C;~Signee may enter upon the property to per1OH/~O 7qqons.
Signature license No. . Date
(Name)
(Address)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATP
16, PROJECT COSTNALUE
17. COMPLETION DATE
I
SETBACKS: Required
Actual
Front
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 V ALUA TION ~z.~.6U PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING _
l?l=;S AIR..
I
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~i~~~~~...1...~...~..~... $~ 5
City:
Amount Brought Forward .................. ,'I::
Park Support Fee ........................... .4:
SAC ......................................... 'I::
Collective Street Fee .......................!l:
Sewer Tap ................................... $
.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
1.2~
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
WalerMeler ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Gas Areplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By D~e
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ............................., $-.:JJ". au
Paid 7(,.00 Receipt No. 7,t:;ri74-
Issued t. ~ ~
Date 4--. 2.2, qt; By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdina and may proceed a equested. 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
CilyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850