HomeMy WebLinkAboutBuilding Permit 99-0682
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
.J No
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
5FINAL
o SITE INSPECTION
COMMENTS:
~
'-
_.
SCHEDULED
DATE TIME
I~ -1-t.-'11.. A:J;
8~d1 .AI.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
6H~~
-----~~_...- -
~.
q ~ - ~ 72-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
~ ~
"
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
In-.
C/~ ~
.J
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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(,/4/~ .
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. t?t?-~e2-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
~EFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
I ~ILrlqSO c, \- <; cL
r (')\(')f~c)
3. LEGAL 'DESCRIPTION
LOT .3 BLOCK.3
L.,II/C.65/VE t!fj;tJ;e.pe:JVf
F\JWNER . ()~ame) I. (Address) I I i (Tel. N9j I~"'.y _"l"\- ~ 14. FLOOR AREA APPORTIONMENT USE
V -t^"'V G g \J V1 c........ I.-Wi () t' (J ,,,(,,vln <t~t \If" '/d"rJvJ ax; <J
ISo ARCHIT~ (Name) (Address) (Tel. No.)
{~BUI.LDER (Name) (Q5'-~~~s7f(r.5g)O flYjfleJJel~o;)
I ~~~ M f.:.ce~ro~.~~~:Jf ~ec~ <sJCf.~0.~71 ~~o~tt :;-
New Construction CI Alterations 0 Addition 0 Finish Anic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
1~7q!?7
I . I '
~/ ..r:C>
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
PID ?5-00(,' tJz..9'-Q
13. TYPE OF CONSTRUCTION
ADDITION
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATF
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 rumi,shed information on is apPIi~n which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
Ihe ab~V~~tion~t~~~~II consl", on will. cr 1 rm to all exishng slate a. nd local laws and will proceed in accordance with submitted plans. I am aware that the
tj'dingr~c} ~e ok '1 N ~'.;US. urthem e. I hereby agree th::;';;/ z::t~t.i:;}n~!Jlay enter upon Ihe property to erioem ne ed' 9ns,
- ("'Signature. . license No. te ~.
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2.C..s t<1 / ~
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
Z-.Tlf<J - ~
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. <1'.
Par1< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permil Fee ................................... .'1:
74.7S
Plan Check Fee ............................. <t
State Surcharge ............................. <t
(.z"r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... !t
Pressure Reducer .......................... $
Meter Horn .................... .... ........... $
WalerMeler ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Penalty ....................................... $-
Sewer & Water Permit ...................... <1'.
~:: d;jol:~ ~~.;e:it~itrwj.ved
By V~.re: Date'" j 1f1
C 'I' !Doc I /
ertl leate 0 upancy
Total. Due ............................... '7~.d 0
Paid 7tJ.. CO Receipt No. ~~+oO
I~~ ~-
This is to _tv thaI the request in the above application and accompanying documents is in accordance with the C~:~oni~g(~inan~ ~d may pr::'d eS!!:!';;;;'i' 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.
City Planner
Date
Special Conditions W any
24 hour notice for all inspections 447-9850