HomeMy WebLinkAboutBuilding Permit 99-0511
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHED'JLED
/6 -/9 "7
;(,1.
~,
ADDRESS
/5,;J,;;X3
Ch.L
Q..o,
o
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'79- SII
o FOOTING
o FOUNDATION
o FRAMING
lESULATION
FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL Y ~
COMMENTS:4;t ~ ~ ~
~ - ~
/~(J/.ff-'<- ;u, "~
--- ----
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~. CALL FOR REINSPECTION BEFORE COVERING
Inspector: 0/, Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~~
.DAle Dcr.cl"l:':.Q.
5/1/qtj
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 ADDREll'-
15 ~63 Oa k Rl'oIa e. c.b'"
3. lEGAL DESCRIPTlON
1. DATE
S{.3/qq
LOT
ADDITION
1
~,..Jt'-
I
c--r: 2 ~
PID :z.5~25J- 001-0
,qooAl.
BLOCK
'€I066
4. OWNER (Name)
gO~17v.C;Q:lmeY"
5. ARCH IT CT (l'lame)
(Address) (Tel. No.)
15,!J:':l.~ oaJ::...-,Ciqe L/r .3b3-Y.Q.K?-
(Address) (Tel. No.)
6. BUILDER
(Name)
(Address) (Tel. No.)
13.33 t.-qrc. IfIcI. BIIIt;f
.B'vt'llc.. ~/,!;),p.
Deck 0 Re-roofingj( Porch 0
Finish Attic 0 Ae-siding 0 Finish Basement 0
llPYji:7Y\ EX.leriDy.<..
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Septic 0
Addition 0
J1>1b
1. White
2. Pink
3. Yellow
File
City
Applicant
permitNo.~q- 5lL
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
OCCUPANTF
SEATS
16. PROJECT COSTNALUE
.1-000 ,-
17. COMPLETION DATE
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumlshed infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitled plans. I am aware that the
~Uildlng,~~ cause. Furthermore, I hereby agree th~81:jq5nee may enter upon the property to perfSi3tqPqtions.
Signature Ucense No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
SETBACKS: Requlrod
Actual
Side
Front
..'"
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2 Fnf7J. cID
USE OF BUilDING -ee-S ,,-j,e..
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
"74-. '1S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennlt Fee ....................... $
Mechanical Pennit Fee ..................... $
I. 'Z- >'"
MATERIAL FilED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS Cl SETS
SURVEY Cl COPIES
PLOT PLAN Cl
Pressure Reducer .......................... $
Meter Horn ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Pennlt ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Duo .............................. $ /(,.CJO
Poid 7".00 RocoiptNo. 3!S/S~
Issued
Doto G'/7/"Q 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 proceedls 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.
Gas Rreplace Pennit ....................... $
This ~ B:.ecom~QWJJJdlldlng Permit When
By~T~ Date
/-
Certificate of Occupancy
24 hour notice for all inspections 447-9850
Special Conditions if any
City Planner
Date