HomeMy WebLinkAboutBuilding Permit 99-0670
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
dL/o'?" +~
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
'bCFINAL 0 PLUMBING FINAL
/0 SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ ~
G
-
~-
r (/~
\......
DATE TIME
/D-~ oSf 9
A.I;
-r~.
9 9 -b 7(;
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
~~
,
/,j~
~--- ,.~--
"- .""
~2::: )
........~j
-
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wo;/!' CALL FOR REINSPECTION BEFORE COVERING
Inspector: f/}- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
e'i;1
DATE RECE1VFD
~/~./tf1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS 1, DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Prinl or Type and sign al bottom) j - ~ 'I - f"
12. SITE ADDRESS
]'10'2. .S''?~......,,'-< Pr/orL"k.. I'1N J,.-S.ln
3. LEGAL DESCRIPTION
LOT ~::r-t'.-- BLOCK
ADDITION L(..<; -w' / ~ s:;
PID 2S ~'7_ tf>, - tJEJ3 - ()
4. OWNER
Ro"../J
5. ARCHITECT
(Nam.)
C.U"..
(Name)
(Address)
r4.f".;""~~
(Address)
(Tel. No.)
6/~ 'f'f(l- 7S'J).
(Tel. No.)
)'117 2.
6. BUII.DER
(Name)
(Address)
0:1. '0 Alk"I/<-t AI'. .s'.
A~.II"'G4'" A",.9~ (l",j"'CL-hs,.J 8,.,,,,J,,/II.c.
7. TYPE OF WORK Fireplace CI Septic LJ Deck 0
New Construction Cl Alterations Cl Addition 0 Finish Attic [j
(T.L No.)
(II\) '1 (I' - 6 '.'-!,-,
Re-roofing~ Porch [j
Re-siding [j Finish Basement [j
107)
/~.
V
Permit No. Cjf -C?70
While
Pink
Yellow
File
City
Applicant
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(I,<-Ijovt-
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. P.!jOJECT COSTNALUE
$ 6.J/t!:lt!1 ~
t.. _
17. COMPLETION DATE
Chimney LJ Misc.
18. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. '3 '1:.- Width Depth Yes No
I hereby certify that I have furnished information on this application which is to the best ot my knowledge true and correct. I also certify that I am the owner or authorized agent tor
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
building o~cial ~oke this penr,lUor just cause. Furthermore, I hereby agree that the city official or a designe~ may enter upon the property to perform needed inspections.
X ~________~ -~. I .~ -u7/,If!.'q~g'"'1 s:.JV-f,
- Signature Ucense No. Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Amount Brought Forward ......,........... $
Park Support Fee ........................... 'I::
SAC ......................................... ,'I::
Collective Street Fee ....................... ,It
Sewer Tap ................................... <I:
I
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
L s-zJl). c./U
USE OF BUILDING
~ ~/#L
TYPE OF CONSTRUCTION: I \I III IV V
OccupancyGroup A B E F HIM R S U
Division 1 234 7t-/.1r
Permit Fee ................................... $
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.......................... ............. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.L'
SOIL TESTS
[j ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
$
Pressure Reducer .......................... 'I::
Meter Horn ....... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
~:s~Fire~ac. :.nnn ~-- ;~I~i~~.~..:il WperlAprlavOj1
By /~ Date ~/'v7f{ 1
. .
Certificate of Occupa cy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ~~
Paid 7(,. VV Rec.ipINo. 3 t'''Jbr
Date ,,/'/..0 By iJI.--.
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning dlrdinance and may proceed a/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
Special Conditions W any
24 hour notice for all inspections 447.9850