HomeMy WebLinkAboutBuilding Permit 99-0667
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
9-,)7-99 _A.T:
ADDRESS -' ~SS 2- fb ""'5$ W ODO C'/ f?
OWNER ~ru-t CONTR.
~
PHONE NO. PERMIT NO. 9'7 - 01/7
o FOOTING o PLUMBING RI o EX/GRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING @) o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: 8"oF
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- LRKSATlSFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~CALL FOR REINSPECTION BEFORE COVERING
Inspector: ' Owner/Contr:
CALL 447-985 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
___"_._._ ... __ .__u_._~.__"___
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
2SITEA~S5 d
J30'::;C;-("/ ,~
. . . __ I
~ - ;;)"'79
)/A K:..-/
3. LEGAL DESCRIPTION
LOT ~ BLOCK
WItLOWS 3eo AOLJN.
140WN~m
15. ARCHITECT
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES
Sq. Ft.
I hereby certify that I have fum.
the aboveff:tt~ed prope
~Uilding o,.~n re .
, r Signature
ADDITION
6 BU}(~r
7. TYPE OF WORK
New Construction 0
I
I
I
(Add,ess) 1'1 I/.L'~ ....>(Tel.~o,) I 15. NUMBER OF OCCUPANTS OR SEATS
U";} 'I r v. Jf-J<-I0' 7r .$~ .~
Jp,,-, D/2-- ~/("'f 111/ 1fL./l-2C:;~u OCCUPANTS
Septic 0 Deck 0 Re.rOOftng CJ--- Porch 0 SEATS
Addition D Finish Attic 0 Re.siding 0 FInish Basement 0 16. ~~AUlE
19. PROPERTY DIMENSiONS 110. CULVERT SIZE I 17.jOMPLETION DATE
Width Depth Yes No b ..../ () - 9 9
d 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
d tha construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~use. Furthermore. I hereby agree that the ci~ offic;.lpr a d~nje may enter upon the property to perf~ needed inspections.
. .:)CJI5''77~ [0 .?';";::;-9?
PID 2S"-/ltJ - ()2LJ-O
(Name)
.&;for'y
(Name) f
(Address)
.~?"3'~
(Address)
D l\ (Tel. No.)
rJ90LG>roOl tIu
(Tel. No.)
v
1. White
2. Pink
3. Yellow
File
City
Applicant
f,;'~~~r~r
Fireplace 0
Alterations 0
License No.
Permit No. q 9 -t,t; 7
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Widlh) (Depth)
12. NO. OF STOR~E~
'~~;e~RUC/;t ..fP
14. FLOOR AREA APPORTIONMENT USE
Da'.
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
.e.e:I ~k
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
,
PERMIT VALUATION
Z~.oV
TYPE OF CONSTRUCTION: r " III IV V
Occupancy Group A B E F HIM R S U
Amount Brought Forward .................. $:
Park Support Fee ........................... $
SAC ......................................... ~
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Division 1 2 3 4
Permit Fee ........................... .... .... $
7c/' 7 r
Plan Check Fee ............................. $
I.LI
State Surcharge ............................. $
Penalty ...................... ......... ........ $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY D
SETS
COPIES
PLOT PLAN
o
Pressure Reducer .......................... $
Meter Hom ................................... $
Plumbing Permit Fee ....................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
:Gy,a,'sFirep,la ~ ermit~. ~...........,.I.d.,..n.g..~.a.et$':"tWVJ1e";.~p'ppj,Ci~ Water Tap ................................... $
~ L~ -L..!l...-t Builder's Deposit ............................ $
( f Other ......................................... $ '?(, c/O
Certificate of Occupancy Total Due .............................. $ A'-
Paid 7 fD . 0 U Receipt No,gS 3"9 <f
Issued I AA/A'
Date ~ / ,,J q q By 'I(;YV'---'
This is to certify that the request in the above application and accompanying dOCl.lments is in accordance with the City ZonIng ~d may proceed J, requested. This documenl 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.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850