HomeMy WebLinkAboutBuilding Permit 99-0512
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED jtJ-ZZ-'j9 Jt--JT:
ADDRESS ,.c;~"7 9 tJ ~ [?~~
U
OWNER CONTR.
PHONE NO. PERMIT NO. 'J9-5"/2-
COMMENTS:
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
;r~
/J --A';' n"':...... n I
"\ tn'J / __ ~
(~ V-P',~J
- -
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.a:FINAL
/' 0- SITE INSPECTION
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: If:; . Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
----~._",.~._.._---------------"'-_._.__.._..._-
fIorimn. {;X-JQ:;/orc,
7. TYPE OF WORK Fireplace LJ
New Construction LJ Alterations CI
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 fumished 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~r just cause. Furthermore, I hereby agree ~/:o.ff~q5 designee may enter upon the property to pert51:"'~iqqections.
Signature License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... q:
$
8~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
J.b'fb.oo
5/7/qi
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Pleas. Print or Typ. and sign at bottom)
12. SITE ADDRESS "',., nO
-...bf, -, /.-.e.rnl e..y r...t' r- (:J f'
3. LEGAL DESCRIPTION
1. DATE
5/7/'99
~/Sj;)
LOT
/0
/
/"1I'9N'O.e
PID 25-055- ()f5' 0
ADDITION
BLOCK
S/~6
L"qlCe
14. OWNER (Name)
l2u~<,e,11 -KOJ.c...1o.oI
15, ARCHITECT (N.m.)
6. BUILDER (Name)
(Address)
I-em~
(Address)
Ctr
(Tel. No.)
t!tJD - ~~;t
(Tel. No.)
"};)q(j
(Address)
jTe1. No.)
bf~-8q() -
8' . 3<'100
AI va . VillI"
Ae-toofing rp Porch 0
Re-siding 0 Finish Basement CI
I.~:>' LaI'C Ind.
Septic 0 Deck 0
Addition CI Finish Attic 0
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
'2.~. ffV
USEOFBUILDING _ Jt!!6S ",,?/,tZ..
TYPE OF CONSTRUCTlON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
7q. 7 J-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
/.?".-r
1. White
2. Pink
3. Yellow
File
Gty
Applicant
Permit No.
9Q-5/2..
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
OCCUPANTS
SEATS
16. PRO~ECT COSTNALUE
b~/,-
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOil TESTS Ll ENERGY DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
Ll
Pressure Reducer .......................... q:
Meter Hom ................................... </:'
Water Meter ................................. $
Sewer & Water Connection Fee ........... q:
WaterTowerFee ...........................4'
::=~:;~;.{~:i~.;e~it Wh2n/.eP~'7
By/~/-~.I. ~/7/7
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $-7(, . OV
Paid "7". () i) ReceiPt,NJ ,.3~ ~
Date S/?/':;9 By""'f/l.t{_ .
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/d 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.
Issued
24 hour notice for all inspections 447-9850
Special Conditions if any
CilyPlanner
Date