HomeMy WebLinkAboutBuilding Permit 99-0484
CITY Of PRIOR LAKE
INSPECTION NOTICE
SCHEDIJLED
ADDRESS
/'1//) /V~ Jljj
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o fOOTING 0 PLUMBING RI
o fOUNDATION 0 MECH RI
o fRAMING 0 WATER HOOKUP
o INSULATION @ 0 SEWER HOOKUP
)!j: fiNAL # -~" 0 PLUMBING fiNAL
o SITE INSPECTION 0 MECH fiNAL
COMMENTS: () X
O~T~
....,.^"".~
''''0;-
TIM~
""....
I}. . '6-71
?9 - LJRl/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~-PLJ:P
v
'1...41 w...K SATISFACTORY. PROCEED
( c2cORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: /OL&'- . Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
5..5
,-----..-.---- ----".'--
~~
Qill RFr.I=IV';,Q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
5/S/CJCf
Permit No.
qq- t.jg'+
I DIRECTIONS
SPAC~S NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
IZSIT/4~l;S?- A!,1TftL ~t-
I
1. DATE
I?o/l"b
>- s-- 9'1
K-f
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
If
gCltlOINS
4. OWNER (Name)
l31ff.rt/- f<ltV 6~1<IAG:'
ADDITION
M r::HJ c:J "e.....
PIP
~-nf
33-IZJ+- 017-0
12. NO. OF STORIES
LOT
BLOCK
13. TYPE OF CONSTRUCTION
(Address)
1lf/1::J...1I11't'T/flrl- ~
5. ARCHITECT
(Name)
(Address)
(Tel. No.1
No/a' ?.so '3
(Tet. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
5EC.~
7.'TYPEOFWORK
New Construction LJ
Fireplace a
Alterations LJ
Septic LJ
Addition LJ
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding}i:' Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. 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 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 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding 0 .CimJtf' pennit tor just cause. Furthennore, i hereby agree thaI the dty official or a designee may enter upon the property 10 perto::r;edFP9,is.
"" - Signature Lk:ense No. Date
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
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
I<' F.S. M R-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION "'Z.. 3--zro .. Vl..)
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... Ci::
SAC ......................................... <t
Collective Street Fee ....................... Ii:
Sewer Tap ................................... <t
$
Division 1 2 3 4
Permit Fee ...................... ............. $
,eI, AS--
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
(. trf
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................ .... .... ........... CI:
Water Meter ................................. Ii:
Sewer & Water Connection Fee ........... Ci::
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
~:~~I~~:t~ilw~~f~~
/ ' .
Certificate of Occupancy
Water Tap ................................... Ci::
Builder's Deposit ............................ $
Other ......................................... $
Total Due ,..,....................".... $ -;.(". '0"
Paid 1~. #' " Receipt No. s~' oS c/
Date!:' I ,r / 1 q By-1::J.t.--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 'Ordi~ance ~nd may proceed as Mquested. 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
CityPranner
Dale
Special Conditions if any
24 hour notice for all inspections 447.9850