HomeMy WebLinkAboutBuilding Permit 99-0575
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/517&
9i~
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ~
~FINAL Cf>l
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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o
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COMMENTS:
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DATE TIME
10-(1(-'79
ArT;
s;c.
'/''}-575
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W't'J.K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: I.V.:tt ( Owner/Contr:
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
-_.._._._--,--~---"...,,_.._~~----,.._._---,_..,,--~---_.,'~-'~--'-"-----
~1
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
~~'1/;t1
Permit No. -.!lq. ~ 7 S-
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 /';;/7 t,
..~ DATE
5- kf'-99
3. LEGAL DESCRIPTION
LOT q BLOCK
S/t/lM:;;er ~jf
1P" Ellen ~ 51...
3
J!../-SD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID 2.;;;~/'S- -0 <1-3-0
ADDITION
13. TYPE OF CONSTRUCTION
. 4. OWNER (Name) (Address) (Tel. No.)
E I Ie fJ ~ :5~1nE ~'/() ~ S"GOlO
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
711.Jd ~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Chimney LI Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. 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
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
building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfo"!1 J8ede.P inspections.
X '--wuJdJ ~4b1._./ 1>//9/(1'1
. Signature -. License No. ' Date'
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Anic 0
Re-roofin~' Porch 0
Re-siding 0 Finish Basement 0
SEAT~
7-: TYPE OF WORK
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
Les ,er/J:...
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION Z rz:rz}p cf"'\...
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSlllUCTlON: I " III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... ~
Sewer Tap ................................... ~
Division 1 2 3 4
Permit Fee ................................... $
7<-1-7 r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
1.1.~
$
Sewer & Water Permit ...................... $
Pressure Reducer .......................... ot
Meter Hom ....... .... ................. ....... ~
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... It
Gas Fireplace Permit ....................... $
Thi~Ji.1.tioll s,rnjes J..L "'ilding Permit Whi. Af{ttJ.
By TI7fffVI-f).::T' ~ Dale ~ I q 9
.~ I
Certificate of Occupancy
Total Due .............................. $ 7(" "VV
Paid 7'~. d() Receipt No. ~S''lO.,-
Date "/,~ flt~ By,f.J..t.-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordi~ance and may proceed at 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
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850