HomeMy WebLinkAboutBuilding Permit 99-0437
CITY OF PRIOR LAKE
INSPECTION NOTICE
f ~ DATE
SCHEDULL1:l I J - J-,q
TIME
ADDRESS
S~93 r~~ S~ ~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
? '1- l/37
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ..ct\
JrFINAL ~ \{]/
o SITE INSPECT/i>N
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:
( )ff
~~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/ft.tA.. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE RECEIVED
4- /2...., /t.tet .
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2, Pink
3. Yellow
File
City
ApplicllIJt
Permit No.
qq--437
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
;;/"7- ,I qq
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS . J
e:::,l-iL.J t?, +:Olrt(J Lt)n
3. LEGAL DESCRIPTION
I B BLOCK
5TDeM'S
4. OWNEr .Il u (r,) (, n c;
5. ARCHri(T
(Name)
pm.25 -2.2."I-t'lIS-C) I
I" f>d)ON . I
c,1-/kJlr~S\~IaC{m s,c\Yt:'J lt' N~1{0 -SNI}
(Address) (Tel. No.)
12. NO. OF STORIES
LOT
ADDITION
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
l\f\j\~(J ~ t'p,.J-
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OA ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished 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
the above mentioned property and that all construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 9fficial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or ~esignee ~ enter upon the property to perform needed inspections.
X ~/tLu;U...q~ ,~2DI3Tl0) flZ-il~<j
V Signature - License No. Dale
\\ Q I '\ I-LIre.. <..QnA\JJ!r 1\ \
Septic 0 Deck 0 Ae-roofing ~ Porch 0
Addition 0 Finish Attic 0 Ae-siding 0 Finish Basement 0
,C57-CiCD
OCCUPANTS
SEATS
16. PRJiECT COSTNALUE
, 501500
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
2 Pill. 61)
USE OF BUILDING -----eF: 5 K/~
TYPE OF CONSTRUCTION: I It III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
City:
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
CoUectiveStreet Fee ....................... If:
Sewer Tap ....................................'t.
$
74.1'5
Plan Check Fee ............................. $
State Surcharge ............................. $
I. l.- '"'
Penalty ....................................... $
Pressure Reducer .......................... $
MeIer Horn ... .... .... ........................ $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Builder's Deposit ............................ It
Other ......................................... $
Total Due .............................. $ -J~. 0 0
P.,d "/~. CO RecelplNo 3Sl>E!2>
Issued
Date 4-~ By ~
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City ZonIng o'rdinan e an may proceed /!; requested ThiS document when
signed by the CIty Planner constitutes a tempora'Y Certificate of Zonrng compliance and allows construction to commence Before occupan y, a Certifitate of Occupancy must be ISSUed
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
CilyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850