HomeMy WebLinkAboutBuilding Permit 99-0466
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
!{)-(!>-'l;J A:r-.
ADDRESS
""7_ .- /J . 0
/S.;L3o ~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qC; - Lf (.C:,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION Y::\'i
Ilf FINAL !lJ3I
o SITE INSPECTION
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 GASLINE AIR TST
o
COMMENTS: "'-1.
1</<1 ~ I~. d-u .
~~ -~~
\!:f~~ -~_ ~
~ -
LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W'!1.K, 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
----'~._---.__._-_.._-_.._.
DATE RECEIVED
4-/2.. q /qq
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~-OD
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -40&
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
. J~-=SO ::F"ol'rlatJJr\ <ShOY<,,"", 'I'D"}
3, LEGAL DESCRIPTION
4-i~1 /cj~
R.ISp
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
,~.E,
12. NO. OF STORIES
,
LOT tlEIE."'. BOrnJDE.
BLOCK
PID
2J5-Q31o-03S-o
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
rron(.; {\f
5, ARCHITECT
(Name)
t-.l()rCj Q ("\
(Name)
(Address) (Tel. No.) <-1'-11- - b~ .
15d-..:2,C :tOir-lau)(\ .shDn'c., 'TYI S.t;.
(Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
13~3 WtlC.. Ind. BlVd
&Jrf\5lJil\e. 5'5-=>81
Re-roofinq)( Porch 0
Re-siding 0 Finish Basement D
(Tel. No.)
8Clo - 3QCX:>
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
_t\P.r 1i:P.0 8-kxior6
7. TYPE OF WORK Fireplace 0
New Construction D Alterations D
Septic 0
Addition D
Deck D
Finish Attic 0
SEAT.c:
Chimney D Misc.
B. PROPERTY AREA OR ACRES 19. 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 01 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 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uildi~~use. Furthermore, I hereb~ agree ~ty;;;'i~5eSignee may enter upon the property to pertorr I:;;~d /qqiOns.
Signature License No. . Date
16, PROJECT COSTNALUE
qlb:t.q::z.,
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Baok
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS D
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS D
SURVEY 0
SETS
COPIES
USE OF BUILDING _~E:.S A/-fZ-
.z:=:. on. 00
PLOT PLAN
o
TYPE OF CONSTRUCOON: I II III IV V
Occupancy Group A B E F HIM R
Division t 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ............. .......... $
Sewer Tap ................................... $
$
Permit Fee ................................... $'
'74."1S"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $:
[,2.5""
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
~~~t:'lt~!t~'1
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......... .... .... ........................ $_
Total Due .............................. $ 7(, .00
Paid 't'(';J() Recelpl7f'. ?'';:)/OCT
Date 4-f.2...qJqq By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning'Ordina~ce 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.
Issued
City Planner
Date
Special Conditions it any
24 hour notice for all inspections 447.9850