HomeMy WebLinkAboutBuilding Permit 99-0422
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/6-/1./-9'7
A::i,
ADDRESS
58"3C. ;IV()/ AN '~/)(;'C: CJ flU
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9')-id~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION~
(.( FINAL
o SITE INSPEC ION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~.
o
k'H71 ~i'- ~n~ B~
.~ ~
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/
LKSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK',~L FOR REINSPECTION BEFORE COVERING
Inspector: r f t ( Owner/Conte
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
-\,~~x PR/~-? (
!::: ~
U en
QATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicant
Permit No.~-4Z?
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
5J.3~
3. LEGAL DESCRIPTION
Cf
OAlC.- t<..l 0 G.. I:;
1. DATE
y~ l (p-f?
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
.:r~
~";Iq IJ
(',:..,;j J
,
12. NO. OF STORIES
ADDITION
c:r:
PID 2S~OPB ~D34--0
I c;.. AOO,0 .
13, TYPE OF CONSTRUCTION
LOT
BLOCK
2
4. OWNER L (Name)
QJ1A.i .A
5, ARCHITECT (NarJ
(Address)
A2uJ.h ~11..1
) - (Address)
(Tel. No.)
J.!.(7- 3/~O
(Tel. No,)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
If'?.;?- 3d'~ ~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~ AtXtf~1
7. TYPE OF WORK Fireplac~
New Construction 0 Alterations 0
Chimney LI Misc.
~ U,; Joo $.'1.
'""'Th..a Ald_
Septic 0 Deck 0 Re.roofing 0 Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
SEATS
16, PROJECT COSTNALUE
8, PROPERTY AREA OR ACRES
Sq.Ft.
19, PROPERTY DIMENSIONS
Width Depth
1'0, CULVERT SIZE
Yes No
17, COMPLETION DATE
I hereby certify that 1 have fumished information on this application which is to the best of my knowledge tnJe and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all constnJction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can re~oke this per~for !ust cause~ Furthermore, I hereby agree that the city official or a designee may enter upon the property to perlorm needed inspections.
X _ '--r--"., J 'kJl ~/l./
- - - Signature License No. Date
FOR ADMINISTRATIVE USE
'ront
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LI
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
- BUILDING DEPARTMENT VALUATION
USE OF BUILDING
f? e:-s A:l L
,
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
'2, ~ _ cn...J
PLOT PLAN
o
TYPE OF CONSTRUCTlON: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 :3 4
"""74- . ''is-
Permit Fee ................................... 4:
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC uu,uuuuu,u.,uuumuu,uum $
Collective Street Fee "..................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. <l:
State Surcharge ............................. ct
1.7-.-;-
Mechanical Permit Fee ............. ........ $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Penalty ....................................... ct
Plumbing Permit Fee ....................... $
Sewer & Water Permit ...................... <l:
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due uuuumuu.u.UUUUU' $ 7"" .cJO
Pa;d 1~ . CO Rece;pt No, ;!.ro7"--
Date t:r/-Vc./t;o, By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoningbrdinarfce and \nay pr~s 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.
Gas Fireplace Permit ....................... <l:
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
CrtyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850