HomeMy WebLinkAboutBuilding Permit 99-0673
DATE TIME
CITY OF PRIOR LAKE , /
INSPECTIONWOTICE SCHEDULED 7f!f"19 4:CT7\
ADDRESS /~379 ~L.t3/1Nr AVE;.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
C;9~(P73
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION 6'\
)( FINAL eOoF ((!:;./
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: (if] ,p?; k~ J ,n-.- ~
~........ -crt/',
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LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~~f' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ *' f Owner/Contr:
CALL 447-t850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
~~
;;;;;;
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qY-{.7-:l,
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 ADDRESS
/k 3 7 q. .4./b""",., ",~,
>
3. LEGAL DESCRIPTION
LOT ~ /,v b'~J'BLOCK
1'~7vl'1~
t../
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PIC ZS-90Z--()13,O
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
~N!I_
5. ARCH~CT
(Name)
h ~c../7t!~.It-<-
(Name)
(Address)
/6377
~/&."O/
(Tel. No.) I
/%-<. 4'&/0 - "-/loC!
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Cr~L l:::;-echeH.....
7. TYPE otWORK Fireplace CJ
New Construction 0 Alterations 0
It: 3 n
("'1.!J-",.<o:!'/ A.~c.
Deck 0 Rs-roofing IJV'" Porch 0
Finish Anie CJ Re-siding CJ Finish Basement CJ
SEATS
16. PROJECT COSTNALUE
Septic CJ
Addition 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Fl. 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
building op:!!al can revoke ~rmit for i5t caus~hermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ...7.J..r~ C/~~ ' t::-;l-<f"7
It-' ./- Signature - License No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
1Z~.f ~~
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z:. c-trlJ ~UV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II HI IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
7'-1. 1("'
Plan Check Fee ............................. $
State Surcharge ............................. $
Pena"y ....................................... $
Plumbing Permit Fee ....................... $
l.vr
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This dJ..L~slding Perm' "[;1 ""fq?j
By JC1N1. Date?
- I
Certificate of Occupa
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7'-, C/V
Paid '1 (p. (/ /I Receipl No. '3 n g' "/
Date 10/7-11{ 1 By ~ /
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning brdi,(ance and may proceed asfiquested. 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 if any
24 hour notice for all inspections 447~9B50