HomeMy WebLinkAboutBuilding Permit 99-0626
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
jq/,+/ ~ ~
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIONt?
FINAL
{f SITE INSPEC ION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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1/
DATE TIME
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A,(.
11 -Iod(,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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LSATISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO", CALL FOR REINSPECTION BEFORE COVERING
Inspector: /0).-- \ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
12. SITE ADDRESS
/tIt:J..{ SA..11L ....J-..-.~"
--; BLOCK ' 3
ADDITION ~UC ( /1; 1'/1 It' qt!::'. Alelt 1,
~\
DATE RECEIVED
MAY L 6 1999
3. LEGAL DESCRIPTION
LOT
14.0WNERC\ (Name)
uAcJ C ~.Il1A 1\1 f'
15. ARCHITECT (Name) ,
6. BUILDER (Name)
Yv\AkL ~
7. TYPE OF WORK Fireplace 0
New Construction C1 Alterations 0
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
91 rhx,
1. DATE
5 ~;;)G~q9'
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
PID ;)C;-J-IS- 033{)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address)
~
(Tel. No.)
't'fP VOSI
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Address)
~ OJ. (j) (j) ~ ~iJ~
""Wi...JI~,IL.I
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
'-t?";;"-'fNJ
Septic 0
Addition 0
Re.roofin~ Porch 0
Re-siding 0 Finish Basement 0
Deck 0
Finish Attic 0
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 infonnatJon 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can T?k.e this ~it for just cause. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X ~~ r:nfJIM2~/'I ~
"Signature License No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
i.JfC, r9il
USE OF BUILDING
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Division 1 2 3 4
Pennit Fee ............................... .... $
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... ~
Collective Street Fee ....................... <t
Sewer Tap ................................... <t
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennn Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & WaterPennit ...................... $
Gas Fireplace Pennn ....................... $
7'--(- 7S
(,-~~
Pressure Reducer .......................... <t
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... 'I:
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $.
Total Due 7\............................ $ . /0 cO()
Certificate of Occupancy ,-y tv j, ;J
Paid ~G' Reoe'pt No '\C;~ 'i
- ~~~~ ~ -~
Th51S to certify that the ,""uest m the above apphca'on and accompanymg documents IS In aeco,dance WIth the City Zomng Ord,nance and may p,oceed as reQue2 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.
This Application Becomes Your Building Pennit When Approved.
By nate
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850