HomeMy WebLinkAboutBuilding Permit 99-0680
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/tJ-/S-'1'j 4:1-:
ADDRESS /~~(;3 ~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'19 - fogo
o FOOTING
o FOUNDATION
o FRAMING
o INSULATI~
FINAL
~ SITE INSP ION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ~_
4-1" ~
~~
\.. (V2~
1t.tJ2..-.f/'-- ~
~~)
/
...........
-
-
.-/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR12CALL FOR REINSPECTION BEFORE COVERING
Inspector: Tel} / Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yas No
furnished' alian 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
rty an hat I construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
. p r just cause. ~rthermore, I hereby agree that the Ci2:il5 r(gsl1rya~ upon the property to perform ~r::o::lt2JS7
~~ ~~No.~-
n'tLJ
&~~
.MIE. RFr.FJVFn
~/3/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDRESS \ \.
\.5~(,,'2, Knr- (illW\ ~hD'(\r.
3. LEGAL DESCRIPTION
1. DATE
~42- 91
Ie 150
LOT
12-
I
PID 25-/7Q, (j/2.-C)
BLOCK
ADDITION
4, OWNER () (N::)O'~ L
"TG\\1:L m" \ ~
(Address) (Tel. No.)
\5d.(,,~ ffiylaWh ~'rrr:Tr. J11.jl .B.3JI
(Address) (Tel. No.)
5. ARCHITECT
(Name)
6. BUILDER
(Name)
(Tel. No.)
\ llil~ lbdllM't1 '-101--0\ D{.)
- Septic 0 Deck 0 Re-rOOfing~ Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Fimsh Basement 0
(Address)
~ca. &:>..JJ.n.t
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq, FI. ./I
(
SETBACKS: Required
Actual
---
FOR ADMINISTRATIVE USE
Front
Side
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION , 2/S7Jl). (fU
USE OF BUILDING
/.2 ~ S ~..e...
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
7(P,IJ.J
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Cf9-(P80
BUILDING INFORMATION
11, 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,. \
f)lq~,lU
17. COMPLE-r10N DAlE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS--1"J
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Division 1 2 3 4
Permit Fee ............................... .... $
Amount Brought Forward .................. $
Par1< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ...................................:t
Pressure Reducer .......................... :t
Meter Horn ................ .... .... .... ....... ~
Water Meter ................................. ~
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... ,It
Builder's Deposit ............................ $
Other ......................................... ~
Total Due .............................. $ -J~. OtJ
Paid 7(,.0 b Receipt No, 35.3QI?!
Date (,/3/'1"1 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin'ance and may proceed af 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.
City:
7<1.75
Plan Check Fee ............................. $
Slate Surcharge ............................. $
Penalty. ...................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I.Z-S-
Sewer & Water Permit ...................... $
This
By
ilding Permit Whei.AP~ed.
Date In.3 ~
I I
Issued
City Planner
Dale
Special Conditions it any
24 hour notice for all Inspections 447-9850
$