HomeMy WebLinkAboutBuilding Permit 99-0634
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEJ;l
/0-1,5>-9'1
?t.r.-
ADDRESS
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./
CONTR.
OWNER
PHONE NO.
PERMIT NO.
99-63'1
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
~FINAL 0 PLUMBING FINAL 0 GA~.N~R TST
o SITE INSPECTION 0 MECH FINAL ~
COMMENTS: ~ ~ .-I~ ~
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l
..............
~
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~K, CAll FOR REINSPECTION BEFORE COVERING
Inspector: 1::/1, Owner/Contr:
9ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
-_._--_.._-~--'-..
8~~
DATE RECEIVED
6"ft~~1
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.
99. (,3'1-
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12S;iiqE~ '1 S7J'PYJ 7 ~G:p.C44
3. LEGAL DESCRIPTION
i12- .
1. DATE
5- .)- b 7/
!i?-I J 0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
LOT
b
BLOCK
PID ~-o<l(#-t)oe-o
~ 01./ d,q:JI"..;H
1
14. OW~ _ (Name) (Address)
fG4{l NO '1 j1.1A.LJ,/R ~
ISo ARCHITECT (Name) (Address) (Tel. No.)
6 j;,o;; 14 {' (~t, 1.-P E;...~ (Address) LIlt / J~!Cl~y-
5s r t7 tv J'5~t:\r..5?r _~;.aG;'~
7 TYPE OF WORK Fireplace 0 Septic LI Deck LI Ae-reolm Porch 0
New Construction LJ Alterations LJ Addltlon LJ Finish Attic LJ Ae-sldmg LJ 1n'ISh Basement LJ
13. TYPE OF CONSTRUCTION
ADDITION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Mis"
18. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
11 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby ce' a 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 abov mention 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
b' g fficia ke. th~ pe~t fo~useo Furthe~, I hereby agree that the city official or a designee may enter upon the property to Q.Srf~eededjnspljFtions
~~~/ J-~~~
Signature / J license No_ Date'
'-./
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
LJ ENERGY DATA
[J
~'YL
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PILING LOGS LJ PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS LJ
SURVEY LJ
SETS
COPIES
PERMIT VALUATION
2- rrn; _ cru
PLOT PLAN
[J
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 :3 4
Permit Fee ................................... $ "74. IS-
City:
Amount Brought Forward .................. $
Park Support Fee ........................... !f
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... !f
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
1.'"2->
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Other ......................................... $
Total Due .............................. $
Paid ~(p.OO
Date <;;/'2.(, /qtq
, .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee 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.
Receipt No.
7(,. c.n)
~r~~"?
Certificate of Occupancy
Issued
By
City Planner
Dale
Special Conditions if any
24 hour notice for aU inspections 447-9850