HomeMy WebLinkAboutBuilding Permit 99-0612
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
LO-/r-?"j' 14. II
ADDRESS
(5/fS7 7~~f-~ 4 /"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION h\ 0 SEWER HOOKUP
1\t"FINAL QV 0 PLUMBING FINAL
D SITE INSPECTION 0 MECH FINAL
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COMMENTS:
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99-&JZ--
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
L SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~, CALL 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/
INSNOTl
'__"^_'____"_'___ ....__.__~_________._.____.._ ....._......._,.._._._ . ..__m_'._________
~~
DATE RE~ CITY OF PRIOR LAKE
Co IJO 5 (0/1 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 at bottom)
12. SITE ADDRESS I
5/<>7 hsA IJn,/i!c-
3. LEGAL DESCRIPTION
1. DATE
O/ki11
;<./BD
LOT
/7
!SrlANG/2J . LA
/
PIC ~5-lfn5 - Of7- 0
BLOCK
ADDITION
4. OWNER
Udyd
(Address) (Tel. No.) t.; 1/ O~
I L)""/<;"7 .p; ;;J, VI) I ','l1-L .sr:;> l
(Address) I (Tel. No.)
(Name)
. J//YJ
(Name)
5. ARCHITECT
6. BUILDER
(Name)
(Address)
hI" k t}JJ<tp-
c;y/ ok OJ( 8-'/-/1/1
~Ra-roofi~ Porch Cl
Re-sidingLJ Finish Basement LJ
M--e l'--
f-oifl.r 1
9 i(Lf
7. TYPE OF WORK
New Construction a
Fireplace (]
Alterations ["'J
Septi~ Deck 0
Addition 0 Finish Attic 0
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq-&IZ-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Wldtt1) (Depth)
12. NO. OF STORIES
13. TYPEJ! CONSTflUCTION
IC rttfJ.!t:!. (J >
14. FLOOR ARa6APP~IONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEAT~
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 information on this application which is to the best 01 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 c~n re..':'.P~ this permit for just cause. Furthermore, I hereby agree that the city official or a designee m.ay enter upon the property to pertorm needed i~ectiOns.
X ~'f'f.~ __ ~Ou Lj,;2";;.Y, ~J~l q1
. SigBIftUre license No. - Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ........................ .... ....... $
Water Meter ................................. $
Sewer & WalerConnection Fee ........... $
Water Tower Fee ........................... $
WalerTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid /6. 0 0 Receipt No.
Dete t:h.,fqq By
This is to certify that the request in the above application and accompanying documents is in accordance with the City ZOnin9 Ordina~e a~d may proceed J 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.
SETBACKS: Required
Actual
Side
Side
Front
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
-2Sl57J. UD
USE OF BUILDING
A2.E..s If / Ii!:?.....
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Permit Fee ................................... $
/4-.'15"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .............. ......................... $
Plumbing Permit Fee ....................... $
'.z..<;;"""
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... It
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
CUy Planner
Date
Special Conditions it any
24 hour notice for aU inspections 447.9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS Cl SETS
SURVEY Cl COPIES
PLOT PLAN Cl
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35".35Q
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