HomeMy WebLinkAboutBuilding Permit 99-0610
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3250
~~.
CONTR.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
K o-rr/
c!~.~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
/!! FINAL
o SITE INSPECTION
COMMENTS:
PERMIT NO.
...-0
DATE TIME
/o-u-?'I' A"T:
~-
T"u. ,
Cf"J-&,I{)
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA~IR TST
.~ i
d~
./
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK'ffLL FOR REINSPECTION BEFORE COVERING
Inspector: m " Owner/Contr:
- /
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
--~..._.
,
INSNOTJ
~1
QAT~ l=!:Fr.FI\{r;Q
S/Z5/Qr
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
1. DATE
5/ n IGPt
2. SITE ADDRESS
_~1. f%)n ~ ,/C'{]vmf)(-f?, \\'.'3.\J\\
3. LEGAL DESCRIPTION
/
I2-I.$D
/
PID 2.5-/1/- 001-0
LOT
BLOCK
VAL-€:
4. QWNER (Name)
\A C. ~t1 n-t-t1J,O~.
5. ARCHITECT (Name)
,<too ^'
ADDITION
(Address)
~L5/)S:~mv('(,\('.~Ill.
(Address)
(Tel. No.)
'2.'2}J ,'1...?,IoCO
(Tel. No.)
6. BUILDER
(Name)
(Tel. No.)
1.7'1..-~~'6 -2.boo
IOOl E ,OiEf tD, Bu({~ulle ~ ,\c.,~?1
Septic 0 Deck 0 Rs-roofing a Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
(Address)
YX\llivJf,.\tl1mbt(otf-
7. TYPE OF WORK Fireplace 0
New Construction a Alterations 0
~7~'~te
File
City
Applicant
2. Pink
3. Yellow
Permit No.
qq-(PIO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF <iO~~TRUCT10N
~~-:\10..0
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ~01I'CT COSTNALUE
if' JJ-t b . C}fJ
17. COMPLETION DATE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yas No
I hereby certify that I have furnished infonnation 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 thaI all construction will conform to all existing stale and local laws and will proceed in accordance with submitled plans. I am aware that the
~Uildingt~a,;:-v1~~~fl~?se. Furthermore, I hereby agree t~~~;ff~~ designee may enter upon Ihe property 10 pertS'/i'1jiE,Sb;"ions.
Signature License No. ale
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. ~
Park Support Fee .... ....................... ~,
SAC ...........,..,..........,............... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Hom .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ CI:
Other ......................................... $
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION z,5l5O. d1J
USE OF BUILDING
/l!.ES /T IE..
I
TYPE OF CONSTRUCl10N: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
74- :15"
Plan Check Fee ............................. II:
State Surcharge ............................. It:
/, 2!-~
Penalty ....................................... ~
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Firepla Permit. .................... $
i~lng ~::il~j'lrftl
. I
MATERIAL FILEO WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
-u. () 0
Paid 7~.OO ReceipINo.3533e.
Issued -
Dale ::{z. S"! qc, By -13t'./c-,
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceedf{s 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.
Total Due .............................. $
24 hour notice for all inspections 447-9850
Special Condilions ij any
City Planner
Date