HomeMy WebLinkAboutBuilding Permit 99-0435
DATE TIME
CITY OF PRIOR LAKE fj. -J. -7~
INSPECTION NOTICE SCHEDULED
ADDRESS S7/d /SOtlj
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OWNER CONTR.
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PHONE NO. PERMIT NO. _97>- <t..Ls
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o FOOTING o PLUMBING RI o EXiGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULAT~ <!f) o SeweR HOOKUP o FIREPLACE FINAL
)f FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0_
COMMENTS:
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X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT/ON BEFORE COVERING
~ Owner/Contr:
Inspector:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CALL 447.9850 FOR TH!; NEXT INSPECTION 24 HOURS IN ADVANCE.
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INSNOTl
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,QATF tU:r.Fl\f~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
:}j)p;
f:-rst '
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SIT~q)~
3. LEGAL DESCRIPTION
LOT TlruT iYl
/~"7-Jh ~-;-.--(~
BLOCK 12 LS fr I
PID ..2..,~-^~- 1114-(
ADDITION
4"OWNE~ (Name) (Address) / (.")f,4 <h/r::::' (Tel. No,)
_/A ()..-A:1JP",1< -fa /:2 f1J7~ 787
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
,4d:l~ &I#.~j~ I<?~ ,r;,,;'(:/[;i./Je Pi, 7c'Jl~%g;;
1. TYPE OF WORK. Fireplace 0 . / Septic 0 Deck 0 Re-roofing~ Porch 0
New Construction 0 Alterations 0 ~ition CI Finish Attic 0 Re-siding 0 Finish Basement 0
I. White File
2. Pink City
3 Yellow Applicant
Permit No.
qq- 435"
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
OCCUPANTo
SEATS
16. PROJECT COSTNALUE
Chimney CI Misc.
R PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq, Ft. Width Depth Yes No
I hereby certify that I have furnished i rmation on this ~. p.IiCation 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 mention~.~:~~ an t all co ructi2"will conform to all existing state and local laws and WIll proceed in accordance with submitted p.'~ns. I. m aware that the
:Ulldlng~Z"~ It for' "7' .....o.....:e. I hereby agree that the city official or a designee may enter upon the property to perlo,;n~e~~ns.
- ... ... - ~ siQnatu( ~ 'l License No. ot 7"'7
Amount Brought Forward .................. $
Park Support Fee ........................... t
SAC ......................................... <t
Collective Street Fee ....................... t
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom .................... .... .... ....... <t
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... t
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7ra.dV
Paid ,I.. cflJ Receipt No. '2 .......-1"
Issued Date .".1.",'qOJ By J(V/'---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ~d may proceed as 'U:~ed. 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.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
z..<S'1>Z) . cfLl
USE OF BUILDING
~s AlIL
1
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
Division 1 2 3 4
Permit Fee ................................... $ -Z 4--.1<)"
City:
Plan Check Fee ......................... .... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
\.'2......-
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $'
This Application Becomes Your Building Permit When Approved.
By Dare
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
17, COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS CI
SETS
COPIES
SURVEY 0
PLOT PLAN
o