HomeMy WebLinkAboutBuilding Permit 99-0499
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DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
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5.500 s~ rMJ NE.
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-'19'1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION f)
t1r FINAL A.:m,{ \lI/
o SITE INSPECrI'ON
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 GAS LINE AIR TST
o
COMMENTS:
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~
';)tWORK 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/
INSHOTJ
(Tel. No.)
7~~~~:\JJ~F~1 ~S! S~~O"L J~~~~e_roOf~3 -~~;9
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc.
R 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
~bove mentioned prope~d that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I a, m aware thallhe
.. off~1 can ref5R~}h . fl(\\jU~. Furthermore, I hereby agree that the citY}2.ffiCiaJ,or~ ~s~nee may enter upon the property to pertorm n~ed i~ections.
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Signature Ucense No. bale
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5/e:,/Cf1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUeD (Please Print or Type and sign at bottom)
2. SITE ADDRESS <:::::'ho - -.-n D. L \, ~
SC;:--DCJ c) Q.l::: \\'-1,\ N,t......
1. DATE
~._y- ~ ~
PUSD
3. LEGAL DESCRIPTION
tl-
S kN 0 .n-: 4- 71f-
(Name)
\(1l'L \TC~'-A(lQ
LOT
BLOCK
7
PID 2.5-2.15- 098-0
ADDITION
PrDON .
(Addr~ _ --:-nn ", (Tel. No,)
'5 csro :J'O\1:t/\1~\L \:i"'L :f..e\-lo~ II
4. "~~ER
,",,-c\0
5. ARCHITECT
(Address)
(Tel. No.)
(Name)
6. BUILDER
(Name)
(Address)
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
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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
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MA TERfAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
Z. nn! . OV PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7h.O 0
Paid 7". en) Receipt No. 3 ~ 1'-1 ?..
Date >/fI/"if 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 to commence. Before occupancy, a Certificate of Occupancy must be issued.
SETBACKS: Required
Actual
Side
Front
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
k!c;S t"r/iC...-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
-;4--, "7<)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
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Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-9850
Special Conditions if any
City Planner
Date