HomeMy WebLinkAboutBuilding Permit 99-0600
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 10 -z.2.-~ A.71
ADDRESS ~95,;l.., ~ ~. J2;,
OWNER CONTR.
PHONE NO. PERMIT NO. 99-~ O()
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
)lr FINAL 0 PLUMBING FINAL 0 G~~I~ AIR TST
o SITE INSPECTION /7 0 MECH FINAL )i?J "~/
COMMENTS: k'~';' ~
rw~-'~~
'-.: ~
LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, Owner/Contr:
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
~~
DATE RECEIVED
s1~.9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1"~4/7
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq~07J
. 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
_:J::J..s;;;?
3. LEGA~ DESCRIPTION
LOT VIO Wl
ADDITlON <:;' r\ ~ vlr\
14. OWNER ~anfe)
~ ~Zd....,,;~
15. ARCHITECT (Name) (
ft. BUILDER (Name)
BLOCK
laJQ I' ()1 A "VI ~ i Je.
r'P
;;(y
elSO
BUILDING INFORMA nON
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
e~
PID;{1)-I~~(J{( -L
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address) (Tel. No.)
r-:J?M1 ('.?~ ~/ G,/d/~J
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
<v-~
r... ... _
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
DeckCJ
Finish Attic 0
Re-roofi~ Porch CJ
Re-siding 0 Finish Basement 0
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. FI. 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
'. he above mentioned property and th~t all struction will confor.m to all existing state and local laws and will proceed in accordance with SUb. mitted plans. I am aware that the
,building ?ffiClal ~n r~ p~it-.!.or j cause. Furthermo~, I hereby agree that the city officia'--or a gesisg~may enter upon the propertr..to perform needed inspections.
'x ./ y-- /~. ~<;'-~-Il
SignaiUfe license No. Dale
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPliCATION
Front
"ok
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
/I!e7 "o/'.f1'-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z rD'D ,<77./
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
7'-1--Z}
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... ~
Sewer Tap ....................................'f
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I.t..-l
$
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..."................ $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Th~n fma- 1.1.4ulldln9 Peoni! When Approved.
By ..- ~- Date
I
Certificate of Occupancy
Issued
Water Tap ................................... $
Builder's Deposit ............................ $-
Other ......................................... $
~? 7;..:.;;v......~~~~i~;..,:.!!:~? 0
Date Si6.~/qq By /~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoninlf Ordinance and may proceed ~uested. 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
"'"
Special Conditions if any
24 hour notice for all inspections 447-9850