HomeMy WebLinkAboutBuilding Permit 99-0662
CITY OF PRIOR LAKE
INSPECTION NOT/CE
DATE TIME
SCHEDUL'ED
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A.(.
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
19~tf,1a2
o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLING
o FOUNDA T/ON 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
ja:::FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECT/ON 0 MECH FINAL ;t _ ~
COMMENTS, ~~ "--,,:.:..
/ (~ ~/ --.:l
(/ ~
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~KSAT/SFACTORy.PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W2 CALL FOR REINSPECT/ON BEFORE COVERING
Inspector: V t ,. . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ~qD~ES; _ 0
4: \t' lp lov.!.eJL c-f-
1. DATE
(p-l -q 7
~2-
3. LEGAL DESCRIPTION
LOT
PID 2-5-23/ ~ 00/-0
BLOCK
ADDITION
"'77J We:Je/ N 6. WI) 1'>0 .s
L (1 I _ (Addres:1
6t- r:\ q fjp .n. '€.V1
o (Address)
(Tel. No.)
4. O~ rF p:amel
5. ARCHITECT (Name)
11 I (Tel. No.)
r .,-. )tog - 3 l./ '1. (,)
6. BUILDER (Name) (Address)
7~~/z~Y\,~gtJr:.,:~~ Deck a
New Construction 0 Alterations 0 Addition 0 Finish Anie [j
lot J.-~~7~6 ~Ciy
~~_. :"l~
Re-roofiri~ Porch [j
Re-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -4.t 7_
BUILDING INFORMATION
". 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.
8. 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. I also certify that I am the owner or authorized agent for
the above mentioned 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
buildinAricill ~n revoke this Pfrm(,for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
xl' .....t.C<A fA. ~ ~ '+0 I I,;"'"'~~ it> (." Co -/ - 'I J
Signature License No. Dale
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7".0 0
Paid 1 (. '. 0 Ci Receipt No.. 'i!:.!;' 37 q
Date 1.6/1/41 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning' Ordi~ance and may proceed alrequested. 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.
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION _
2.~u u.OlJ
USE OF BUILDING
1Z6 s "./,.e,
,
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City,
,t./.. ,e;-
Plan Check Fee ............................. $
State Surcharge ............................. .'I:
1.z..S
Penalty ....................................... <t
Plumbing Permit Fee ....................... <t
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplac P rmit.. ................... $
s "'''Wing ;:'';'' {;etrftry
lr'- 'I
Certificate of Occupancy
Issued
City Planner
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS Cl PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY a
COPIES
PLOT PLAN
a
24 hour notice for all inspections 447-9850
Special Conditions W any