HomeMy WebLinkAboutBuilding Permit 99-0498
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/6-lr-?'J
A.T:"
ADDRESS
1<l2c3to r!kJiJ LE l()(Jon Uhle-
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
4~
...",--
( t'l Lr.U
'- .
--
...
99- 4f'lf
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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~~
fI WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspeclor: 6;-
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNQT1
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicant
S!v/t91,
Permit No.
19- t/9r1
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign al bottom)
1. DATE
112
~
ff
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS
LIf.)' '] (a
3. LEGAL DESCRIPTION
(l~~PIM~J) J~
12. NO. OF STORIES
LOT
Jz.
BLOCK
ShNO ,177
2-
4- 7rI
PID .2,.15 - 2/,~ - ~22-(,)
fiVOrJ
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
r /,.." J) (1) J/u,,"d
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
.~
6. BUILDER (Name) (Address) c:J.IV-, ...........JV(Tel. No.)
7'TYPE~~~;rep~pg~ R~l~~::
New Construction LJ Alterations LJ Addition LJ Finish Anic LJ Re-siding LJ Finish Basement LJ
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. 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 Ihe besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and thaI aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thallhe
:uilding Offk:i9j:' revoke this nn; f j us ., nn e, I hereby agree that the city off;o;al or?\!~: (? enter upon the property to pertor ne.n:i:sPqns.
I 19n ture UcenseNo. t Date 1 ~~
FOR ADMINISTRATIVE USE
17. COMPLETION DATE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
D
BUILDING DEPARTMENT VALUATION
./2.1:: ~ I"rl/'L...
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION :L....-zrv_ V<..I
PILING LOGS LJ PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
PLOT PLAN
D
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A
Division 1 2 3 4
Permit Fee ................................... $
S U
Crty,
Amount Brought Forward .................. ~
Park Support Fee ........................... 'I::
SAC ......................................... ,'I::
Collective Street Fee ....................... $
Sewer Tap ................................... <!::
$
71./. 7>
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.z,r
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ............ .... .... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $_
Total Due ...........,.................. $ 7<':',0 <'
Paid 1C..O c) Rece;ptNo. os/+I
Issued
Date s/ ,It:;") 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 a requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction 10 commence. Before occupancy, a Certificate of Occupancy must be issued.
Certificate of Occupancy
City Planner
Oate
Special Conditions it any
24 hour notice for all inspections 447.9850