HomeMy WebLinkAboutBuilding Permit 99-0580
CITY OF PRIOiJ.A~
INSPECTION NOTIC
DATE TIME
SCHEDULED
#;
11-. T.
ADDRESS
5S~7 CAN 01./ Co V6 ~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq. 580
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRADlFILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
8.lIRU'LACE
r.~ RNI'tl.-
COMMENTS:
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A..-n.v1".........., ~~jJ. ff
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'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND(OCEED
o CORRECT WOR~ n R REINSPECTION BEFORE COVERING
Inspector: D,~, Owner/Contr:
U
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
~1j\~ I 9 'r;?G
Permit No.
QQ-s0
I 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 II . '" I' <C'r-
591 7 ~ t!l!:LI, JC-, ~ (aK~
3. LEGAL DESCRIPTION
PlOd) --13k . "72-()
1. DATE
5!,q )qq
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
BLOCK
fJ1f'TFS rnf j2y()//nds
14.0WNEBo (Name;,...,
DVlJrc:. I LlJ.5VhJi5
15. ARCHITECT
6. BUILDER
LOT
13. TYPE OF CONSTRUCTION
ADDITION
(Name)
(Addr~
(Address)
(Tel. No.1
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
&a,fY\L
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing ~ Porch 0
Re-siding 0 7l=inish Basement 0
SEATS
16. PROJECT COSTNALUE
8. 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
buj off' i ca~ rev ke this permit for just cause. Furthermore, I hereby agree that the cily official or a designee may enter upon the property to pert~ needlJd inspections.
X I .::.zLlq tqi::/
License No. Date
17. COMPLETION DATE
Signature
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
PERMIT VALUATION
,-)<zX) - 00
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS tJ ENERGY DATA tJ
PILING LOGS tJ PERCOLATION TESTS tJ
PLANS & SPECS tJ SETS
SURVEY tJ COPIES
PLOT PLAN tJ
Front
Back
Side
BUILDING DEPARTMENT VALUATION
USEOFBUILDING >>c, 11:11(
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park SUPPOl,1 Fee ........................... $
SAC ......../.................................. $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ............................... .... $
iLl.7S
/..)<{,
Plan Check Fee ............................. $
State Surcharge ............................. $
Penally ....................................... $.
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & WaterConne~ion Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ It
Other ......................................... or
Mechanical Permit Fee ..................... $
Sewer & WaterPermlt ...................... $
.
When Approved.
Certificate of Occupancy -....'1. To1tal Due ...0......................... $ ..-- r- ~~ ~ (XJ
Paid 0 ,cJ Receipt No. -;; <;3 (D
Issued
Date 5-A L["J By (lv LA )
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 requ~ed. 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.
City Planner
Date
Spec~1 Conditions if any
24 hour notice for all inspections 447-9850