HomeMy WebLinkAboutBuilding Permit 99-0656
DATE TIME
CITY OF PRIOR LAKE
INSP~TiON NOTICE SCHEDULED /c:l-Z-Z-?? A.,V';
ADDRESS ,Z::;<; /1 I /5CJ ~ ~,
OWNER CONTR.
PHONE NO. PERMiT NO. 19-'/" S(n
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
JIll' FINAL
/ d SITE INSPECTION
COMMENTS:
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
)'t~
~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
R~ ~
~
----
.....
~.
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---'
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: VI' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCI;,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
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~~
DATE RECEIVED
~11/f1'
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 9'1-".5~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
1't,Tit 191
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
K t;rm~ES:
, .
3. LEGAL DESCRIPTIo/'
LOT L/-
/gJ#
~+.
BLOCK
/
I S"-
12. NO. OF STORIES
ADDITION
prD ZS-ZtJ2...- tJOt/-O
flDoN
13. TYPE OF CONSTRUCTION
/010.; Sr;eOM
'< ~ameTV~K'<;O^tdreSS)
5. ARCHITECT (Name) (Address)
SII1W1E' "JS
14 Bcv~
(Tel. No.)
4(/7-1025
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.) I/YS-7tf3~ 15. NUMBER OF OCCUPANTS OR SEATS
~38~ e.he5/n4. ~CUPANTS
. SEATS
Re-rooflng,J("'" Porch LJ
Re-siding 0 Finish Basement LI 116. PR0565'OE
I ~'O~T/5'9J
x:
5ff(J-L~E{ (t::f( ~o.N;[fUf.n.ON'J
7. TYPE OF WORK Fireplace [j Septic 0 Deck 0
New Construction LJ Alterations 0 Addition CI Finish Attic D
Chimney jj Misc.
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Sq. Ft. Width Depth Yes No
1 hereby certify 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 above mentioned prope a that all construction ill conform 10 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin . ial ell" revc s rmit fa . st s ore, I hereby agree that the city official or~Sj~ee may enter upon the property to rm needed' specti s.
X ~07(LZ"3
-. Signature License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Bad<
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~A1L
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~/OV
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A
Division 1 2 3 4
Permit Fee ........................... ........ It
S U
City:
Amount Brought Forward .................. $
Park Support Fee ............. .............. $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
1'-1. 1)"
Plan Check Fee ........ ..................... $
State Surcharge ............................. $
Penalty ............................... .... .... $:
Plumbing Pennit Fee ....................... $
I.z...r
$
Mechanical Pennit Fee ..................... $
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... It
';:Er41i:::~i'l'/;tj
I3Jj;Jf.J; I ,
Certificate of Occuparty
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ '/(. .00
Paid 7 r, . (IV Receipt No. .!.!; 3"1 L
Issued / /
Date (.., " qc, BY~./o--/'
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed JJ;u~~ed. 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.
CityPlann9l'
Date
Special Conditions if any
24 hour notice for all inspections 447-9850