HomeMy WebLinkAboutBuilding Permit 99-0496
ADDRESS
/ t 3d '7
DATE TIME
SCHEDULED /,J-l.y cj
/V~ t..tJ N VII
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
r "1-'19 {
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON . -J 1'./\
I!f FINAL "'" ~~O IllJ
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
I _
C/t'!
~~~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~ Owner/Conlr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
~~
,QATFRF'C.,
5/ (p /91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1 White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq-L/110
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
2. SITE 1&R3z. 7
0/-'23-'17
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
AJ~()((/ P.ct MAJ
3. LEGAL DESCRIPTION
LOT fo5/(Ph BLOCK
/vOe77iW()OQ
12. NO. OF STORIES
PID 25 -I <H- 04-/- J
ADDITION
13. TYPE OF CONSTRUCTION
14G~RV ~~ l'3L7drass~J ((d.. (Ty~d 57"/2_
15. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
lloMffl'rieTVlfSCi1\J (oM!- ')7r7 {)JI/~ sf cjt./()-J79]
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re.roofi~ Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
Chimna~~ R..- fJ.,.)/~ c.Iu~ -t.. te., Act-lit \JI,(l~ oN br- 2;O(} 0
Ie. PROPERTY AREA OR ACRES 19. PROPE-RTY DIMENSIONS ---~Cl1LVERT SIZE 17. COMPLETION DATE
Sq. FI. Width Depth I Yes No S- _ -x.. q-qq
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 stale and locallaw$ and will proceed in accordance with submitted plans. I am aware that the
:Uilding o~e Ihi~ cause FllrthRrmnrR I hereby agree ~~~~~tto~ee may enter upon the property to perf2;1_ nZ~d-?ftions.
r $"ignature Ucense No. Date
SEATS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
USE OF BUILDING
RGS .4/-'<-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION -Ze;-zJ(). cf?)
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
PLANS & SPECS CI
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. <I:'
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Division 1 2 3 4
Permit Fee .............. ..................... $
Plan Check Fee ............................. $
7,j.7~
State Surcharge ............................. $
Penalty....................................... $
1.2-5
,
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................ .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... <l'
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This ~o~z:s xAr!iiJilding Permit Wh~n pr~ed.
By I ~I 7.YL Data S (" /qq
I
Certificate of Occ pancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 16,.00 RaceiptNo. =?s/37
I~ / I
Date s; 'i" ~ By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed Krequested. 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.
/~.Oo
C~yPlanner
Date
Special Conditions K any
24 hour notice for atl inspections 447-9850