HomeMy WebLinkAboutBuilding Permit 99-0684
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
7~~...2 ;:30
ij 13 / / .l3c...J.J F;:: HTS ~
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q 9 - (p~';'
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDA nON
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE /
/if ~tJF./UO/N'
COMMENTS: (if) tJ p-p7J -' S ~ ~. o--h?
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o ytoRK SATISFACTORY, PROCEED
rI CORRECT ACTION AND PROCEED
o CORRECT ~~. l FOR REINSPECTION BEFORE COVERING
Inspector: ,_~ J Owner/Contr:
-- V
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
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CITY OF PRIOR LAKE
BUILDING PERMIT,
. TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9q~C:& 4-
1. DATE
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
L-(~ I }
3. LEGAL DESCRIPTION
./~
BLiAtt 1-I1':;<;t.J.~
Irk
\)Af-J Ol=-7J
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing"Jl'a- Porch 0
New Construction 0 -Alterations 0 Adqitior:lD Finish Attic 0 Re-siding)f Finish Basem to. 16. PROJECT COSTNALUE.---
Ch;mneyD Mise _~_i;eL 1-"-./ I A' "5 EbMss vVINLX:><-vS W L. ~ l1., 000
8. PROPERTY AREA OR ACRES 190 PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLE nUN DATE
Sq. Ft __ W;dlh .....----Depth.__ Yes ",,----No -- L A t-t: J' 'A <l\J 1.<::-
I hereby certify that 1 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
th~ ~bove :ten. n~~rty a~~ a!1 construction will conform to all existing state an~ loea. .' !aws and ~II proceed in accordance with submitted plans. I am aware that the
bUilding 0 18 n 0 thiS P Just cau~urthermore, I hereby agree that the city offiCial or ~ee ~ enter,n the property to perform neede1 ~.nsp s.
X t'_ _.Ifh..- --0 ' -- ~Jq -f,;.. - f'
Silrnatur8 License No. . Dale
LOT
BLOCK
ADDITION
4. OWNER
./"
H';,\"'
(Name)
tJ,c
,~) A
5. ARCHITECT
6. BUILDER
(Name)
"B()OM
I /
\-),--v,<:Cf
(Address)
i1"~rU
~ (Address)
(; - 4-rn
if-' IZ.'"L
.z.s;:J"l- OOs -0
PID
bklol+0 '*-Do
(Tel. No.)
13. ~::'CONSTR~CTIO..N L
f,1::::.I'~od I::.
14. FLOOR A~RTIONMENT USE
----
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Hei~. (Wi~ (Dep,!bl--
12. NO. OF STORIES
---- ---
(Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCC~TS OR SEATS
OCCUPANTS
Hot'1C5
Lf b/ - dfjC] if
----
SEAT~
SETBACKS: Required
Actual
Front
BUiLDiNG DEPARTMENT VALUATION
USE OF BUILDING
(
IliX A IlL
TYPE OF CONSTRUcnON: I II III IV V
Occupancy Group A B E F H , M R
Division 1 2 3 4
Permit Fee ...................... ............. C!:
Plan Check Fee ............................. It
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer&WaterPermitt...... ......:'"....... $
FOR ADMINISTRATIVE USE
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS D PERCOLATION TESTS D
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY D COPIES
PERMIT V ALUA TION t~oo - PLOT PLAN D
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
74'1<
r.2-)"
Pressure Reducer .......................... $
Meter Hom .................... ............... $
Water Meter .................................!!',
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... ~
This
By
Certificate of Occupancy
Issued
Paid 1,=,.~
Dale I.!A-Iqq
,Co."""
Receipt No. -z,,, 4 of
By 1-iJ J1
Total Due .............................. ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document wilen
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.
C~y Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850
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