HomeMy WebLinkAboutBuilding Permit #99-548
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
ISO 7Cf
SCHEDULED Jd-7 -''1'~
~~ K./)
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7 '1-. <;'15<
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION / ' 0 SEWER HOOKUP
Jl" FINAL ~ ,.. 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/") / /'
(///
c:.iJ<w ~
v
~ORKSATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/R-A
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
K1
&~~
JlA[I;J'I'''I''''I'n CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq-54f5
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
'<';D14 (Y)(1(\i 1-DL<... 7.d-
l'
DATE
1{.ILf.CftJj
/2/50
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
J<' r>P t?<:;
BLOCK
&..
PID
t5"-osl-a:t. -0
LOT
(~
ADDITION
14. jlWNER ,
OfU}. (,
15. ARCHr(jcT
6. BUILDER
fflO/V'
13. TYPE OF CONSTRUCTION
(Na",e)
1/W'ndtJ.-;
(Name)
(Address) (Tel. No.)
L.tJ.ASDI\ ~ (Uj MvYl..- t.jLn -J35l
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Name)
5Aa1E--
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic CI
Re-roofing^ Porch 0
Re-sidinK" F~ish Basement 0
SEATS
16. PROJECT COSTNALUE
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 furnished inf 'on 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 thi: all co struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUildi01. fficial Cfln r!"vcf.e this p~rmit )r ju use. Furthermore, I hereby agree that the city official or a design.ee may enter upon the property to perlo~~e~ i')SpecJi9rs
X U/'r. ,L.-tc...l ~ 2IV\SJ~ ::> . )'-f . '1' c;y
Signat,.'e License No. Date . I
17. COMPLETION DATE
r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
CLANS & SPECS Ll SETS
SURVEY Ll COPIES
PLOT PLAN Ll
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
rW;
/
kilL
I'
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
25Gb. (Jb
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A
Division 1 2 3 4
Permit Fee ................................... <I:
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
14.1<)
Plan Check Fee ............................. <I:
State Surcharge ............................. CI:
Penalty ....................................... $
~
! _ "L..'-,
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Mechanical Permit Fee ..................... <t
This
Sewer & WaterPennit ..................... cr:: Water Tower Fee ........................... $
...........~ Water Tap ................................... $
,BuHdlng pe"""w~edre~. L BuHde', Deposit ............................ $
Date L-., ~ Other ......................................... $
/ Paid Tm~...................~~~i~;~O$ 3.;r~8Cb
Issued ~
Dale '":J / '4 lC;y By fU) I J.
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 as 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.
By
City Planner
Dale
Special Conditions n any
24 hour notice for aU inspections 447-9850