HomeMy WebLinkAboutBuilding Permit 99-0614
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/0-/"-'19 /t,Y-;
ADDRESS
/.e::;~?7 ,,~-,,_ -., ~~
t'
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
)i:[ FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: e/ L ~
~~.
'--
'7'1-~ lif
o EXlGRADfFlLLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
yr ~
~
- .............-.....
7L~ :))
-
~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: rq. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
I/VSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
DATE RECEIVED
5/2-5/99
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 at bottom)
12 SITE A9~E;; PYI ~. A
/~'7' 'n <:;7/e/':::;";A/ (7/l'Prfk
1. DATE
S'L'
5:95'9')
t::.I.>Q
3. LEGAL DESCRIPTION
LOT
5
BLOCK
ADDITION
4-
&iATFV1/AV s: i+OtzES
PID z.S' - I)q / -0 2..0-0
~ER' ~"'I') (Address)..
/Jf~<j- l/k(Lj59"~~.l'&- 5/
5. ARCHITECT (Name) r (Address)
(Tel No.)
Y"V;1- 25 t:o'f
(Tel. No.)
6. BUILDER (Name) (Address) (Tel No.)
~ 7JAllt];t{.ltfi'(;I/.i/f ~{/J4:,/v,J;11-M' Iw '/fL#f- YE/-5/;c;.
7. TYPE OF WORK Fifeplace d' "Septic 0 Deck 0/ Re.roofing~" Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Ae-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99 -(~;! ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
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 ~rtlfY)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 abQlf6 mer]1:ioned 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
bUildi~ Offici'- can reVOke, thi,~ p~or just caus~. Furthermore, I hereby agree that the city o:icial or a desi~~e may enter upon the property to perform _needed insp~O~.
X ,,/.hA'..~A-0., /,::l/)O~'7f./()~. 5- ,~''7''3
,I 1-.4 -SlQI'lafUre - - - . Ucense No. Dale
Amount Brought Forward .................. tI:
Park Support Fee ........................... $
SAC ......................................... or
Collective Street Fee ....................... <t
Sewer Tap ................................... $
.
Pressure Reducer .......................... It'
Meter Hom ................................... $
Water Meter ................................. <!;
Sewer & Water Connection Fee ........... cr::
WaterTowerFee ........................... $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION -Z~l. v<-
USE OF BUILDING
Ji!EI aJ ~
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
"74- :1)"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penahy ....................................... $
Plumbing Permit Fee ....................... $
/.z....r
Med1anical Permit Fee ..................... $
Sewer & Water Permit ...................... $
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS
LI ENERGY DATA
LI
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY LI
COPIES
PLOT PLAN
LI
Water Tap ................................... <t
This Builder's Deposit ............................ $
By Other ......................................... or
Total Due .............................. $~' () 0
Paid -76. OD Receip\)Jo. "3,"".4--1
Issued Date i> p c:-f::lq By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ....,ull.Lv'" arld may procee<!i! 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.
City Planner
Date
24 hour notice for all inspections 447-9850
Special Conditions if any