HomeMy WebLinkAboutBuilding Permit 99-0654
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
~LL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
~~
SCHEDULED
ADDRESS
5 ~o 3J.JJ/lA1 C-t,~
CONTR.
OWNER
PERMIT NO.
PHONE NO.
-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION~ r.:J
):!! FINAL ;l \t1I
o SITE INSPECTI N
COMMENTS:
-
eM
-
~ {.r-
-
-
Inspector: .
/J\{J
owner/contr:
INSN011
DATE
TIME
(J..- :}. 11
99- tSLJ
o EJUGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
0_
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
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[lATF RFr.FIVFn
6// /C;a;
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRE~
J'in] .J;v"'-I'L,...-~4
1. DATE
.r /2' A b;
3. LEGAL DESCRIPTION
4-
Z-
PID z,>""-o"7.3 - 02-1-0
/$"r FrDOAl
LOT
,LOCK
ADDITION
/-fIOO~ / 0 A-CS
14. OWNER (Name) (Address)
JD(, .oP/vr"OV-ll SQOJ hv...-.'
15. ARCHITECT (Name) (Address)
6. BUILDER (Namel (Address)
A-pr.c:..... $",1,)"--:'5 (,;~;...~.;."r.1
/22.'17 M,'<>/4f AJ".s.~ft.
7. TYPE OF WORK Fireplace LI Septic LI
New Construction LI Alterations LI Addition LI
c.,v,;"
(Tel. No.)
(6"L)'f'fp./ '1n
(Tel No.)
(Tel. No.)
(t:iz)7t>7- 6th?
Re-roofing;T' Porch LI
Re-siding LI L_ Finish Basement LI
DeckLl
Finish Attic LI
'-~61
I. White
2. Pink
3 Yellow
File
City
Applicant
q? -11>1
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONj\TRUCT10N
r~rQcH'
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16J?~ECT CO~ALUE
'5.6'00-
17. CGMPLETION DATE
Chimney LI Misc.
IS. 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 of my knowledge true and correct. J also certify that I am the owner or authorized agent for
th~ ~bove. ~.entioned proP~~ d th:p. at . construction will conform to all existing state an~ 10~1 !aws and v.:ill proceed in accordance with submitted plans. I am aware that the
bUilding ~~, W,jlmlt f st cause. Furthermore, I hereby agree that the ~ offiCial or a deSignee may enter upon the property to pertorm0eded inspections.
X -zc::;.r~ /7, ' ON q Ji'J J >.;~ If
" <-- '- .....- SignaIDre License No. 15ale
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Baol<
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
~ ,.q-/ IC.-
PERMIT VALUATION
z..rzrt; /~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
...,J."1r
Plan Check Fee ............................. It.
State Surcharge ............................. $
/.""l.-'
Penalty....................................... $
Plumbing Permit Fee ....................... <t
Mechanical Permit Fee ......... .... ........ $
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA 0
PILING LOGS LI PERCOLATION TESTS 0
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
PLOT PLAN
"
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
:~r~I~I~~i:t;itWl:1rlll~
, f
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $----AJ-...Jf)-
Total Due .............................. $~~
Paid -J (. . C)" f) Receipt No. ~ r'1 "71
Date f#/I/ fq By J'L1A- /
This is to certify that the request in the above application and accompanying documents is in accordance with the City ZoningOrdinance and may proceed aI 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.
Issued
City Planner
Date
24 hour notice for all inspections 447.9850
Special Conditions ~ any