HomeMy WebLinkAboutBuilding Permit 99-0474
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDU~ED
o.~J'iJ
ADDRESS
snL/
/60&.a... s.c.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'1''1 - (j1 '-/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION../ .6f)
. FINAL ~I \QI
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 GASLlNE AIR TST
o
COMMENTS:
/YI.i'.-w- ~ ~ r/. A~~
I ) "----Cr
~d ~' Olr
e-&.LW ~
)l( WORK 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
~~
QATF= RH":FIVFn
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MAY - 3 1999
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRE~q tf.
1. DATE
5/~/CJ3;
(SQ1:!!:,.,A.t.J'E "5~. . I "- IS..D
PlDd)--OL/7 - O{J;)-{)
l.sf ;t~d II)
3. LEGAL DESCRIPTION
,
LOT
BLOCK
f5ftSTwo~D
ADDITION
4. OWNER
(Name)
~k
(Address)
(Tel. No.)
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Address) I'" _I ..l!.-I' (Tel No) (:, { ';l..,
~"1 s "'.i&./>-I tee~,o
,-/~~}-.J;.J,I~ <i-I.
(Name)
g~JDut-Qblf,LtA (I~,
7. TYPE OF WORK Fireplace LI Septic D
New Construction D Alterations D Addition D
Deck D
Finish Attic LI
Re-roofin~ Porch LI
Re.siding D Finish Basement D
Chimney LI Misc.
8. PROPERTY AREA OR ACRES
Sq. FI "
I he
the abo ntioned property an
building 0 ici
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. q q -t./ 7 c.I
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
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
rmation 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
hat I constructi n will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
st cause. urthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
. S/~eA
.. License No. 1 Oat
Amount Brought Forward .................. $
Park Support Fee ................. .... ...... $
SAC ......................................... $
Collective Street Fee ....................... $.
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......... ........ ............. .... ....... $
Total Due .............................. $ 7t,. 00
Paid '1 f. . 04 Receipt No. :3 Sil C-
Oate ~/s/'t., By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdin~nce and may proceed as ;equested. 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.
x
l...:.L....~~
l
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
B.ok
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Z. r:07> . f:/l.)
USE OF BUILDING
eF3 /H IC.-
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A 8 E F HIM R
Division 1 2 3 4
Permit Fee. .................................. $
S U
7~7)
City:
Plan Check Fee ........ ..................... ,II:
State Surcharge ............................. <t.
Penalty. ...................................... $
1.2....r
Plumbing Permit Fee ....................... <;:
Mechanical Permit Fee ............. ........ $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
~~i~1~--7~;:,:"itW~~L
Certificate of Occupancy
Issued
City Planner
Dale
Special Conditions n any
24 hour notice for all inspections 447.9850
17. COMPLETION DATE
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