HomeMy WebLinkAboutBuilding Permit 99-0438
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOUl'ED
ADDRESS
/1118'1 ~ tiN NE.
OWNER
CONTR.
PHONE NO,
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
-.s INSULATION _A.:.n/A)
pFINAL .I\t2~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
0),
(~
/A:B
V
DATE TIME
id.-'? -11
9'1- '13R
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~,Owner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
f5.
- --.---.---..--..-.---
~~
~F ~ CITY OF PRIOR LAKE
~ v' 6f1 ,- BUILDING PERMIT,
I ' TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~1r;;;~1
I. White
2. Pink
3 Yellow
File
City
Applicant
Permit No. qq - 4-..3E)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
ADDITION
2i4EI~iEj) ~ i...
3. LEGAL DESCRIP;(;; .
5
~D
(Name)
1'-1 l5'1
ME..
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Haight) (Width) (Depth)
LOT
BLOCK
PI
3
7~
12. NO. OF STORIES
(Name)
, I (Addre,,>
H>.t?~'" ftJr{.
V (Address)
PIO 2.5-2.Q~-()2-4-'O
Af)ON
AlE-
13. TYPE OF CONSTRUCTION
4. OWNE". V
&11,-,,--
5, ARCHiTECT
(Tel. No.)
Li'/')"- n 7<1
I
I
I
(Tel No) g'1'f - me-
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6 BUILDER (Name) (i"..l f_ _ - __\Address)
\.::>1c...oJ<- '-DC1 V'1r,:;;O.l
Luss 0 ~~""d~ ""'-+_ <)4-D vVIJ~Jeor) JV"\',) fb.,..v-. )vll~
7 TYPE OF wo~ Fireplace u septic d UecK CJ Ae-rooflng CI Porch CI
New Construction ('J Alterations ('J Addition ('J Finish Attic ('J Re-siding)( Finish Basement ('J
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
SEATS
16. PROJECT COSTNALUE
Chimney a Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. 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
th~ ~ve ~entio~pe~ and, that all construction will rontonn to all ax;sting state and local laws and w;U pmceed ;n accordanca w;th suOm;"a" Pljn;H;mr;;are that the
bUl1d1 offl alla IS permIt for Just cause. Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform eded ections.
X f\ -4" 1'S'"LlR.'1 L 7
\ SlQf1ature License No. Dlte
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Bark
Side
Side
SOIL TESTS
('J ENERGY DATA
o
BUILDING OEPARTMENT VALUATION
e.e>s. Ale....
OFF STREET PARKiNG
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS CJ PERCOLATION TESTS D
USE OF BUILDING
PLANS & SPECS 0
SURVEY CJ
SETS
COPIES
.c:.-"O:>uu.~
PLOT PLAN
o
TYPE OF CONSTRUCTlON: I II III IV V
OccupancyGroup A B E F HIM R S U
Cny:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ...................,..................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... CI:
Meter Horn ................................... .'1:.
Divit;ion 1 2 3 4
74-.7S
Permit Fee ........................... ........ $
Plan Check Fee ............................. $
State Surcharge ............................. $
1_ Z.r
Penalty.............. ......................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... c:
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
~ D~
7{,.<J 0
Pa;d "7 fRo or; Rece;pt No. 3 so !Jt'
Date A-/?.-t/tI."I By IJIA--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinan~e and may proceed ~ 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.
Total Due .............................. C:
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850