HomeMy WebLinkAboutBuilding Permit 99-0697
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDUL~D, /u 'Z2-99
~ ---.:
ADDRESS
7"/ 9 P
~~,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'J9 -(p 9 '7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
hFINAL
!' d SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 G~'~E?AIR TST
o MECH FINAL ~ .
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-- - ---............
( (f/~ '~ 'Y
...............
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORYALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ .. . Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNQTl
-.,--'._------- .-..--...---..--.--..--.-----
&~~
DATE REC!;"IVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
& --e -19-
Permit No.
Clef -697
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
~/J q'A
3. LEGAL DESCRIPTION
~
1. DATE
&. ~-99
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
Pkt15tJYJ+
6-1.
,).
PID d'S -(X)6 - O/J-{)
12. NO. OF STORIES
LOT
BLOCK
ADDITION
4. OWNER J:y; ~Name)
5. ARCHITECT (Name)
13. TYPE OF CONSTRUCTION
(Address)
C-mIc1~ 4/1'8 fJha.VJnl-SI-
(Address)
(Tel. No.)
i./l/IJ - &;JS<./
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUilDER
(Name)
,.-J.J-, (Address), J
931-J-=>' . 'Ave f\-li).
.s ,5I-.!b...u.1 OW
(Tel. No,)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
l)+8~~'1
7. TYPE OF WORK
(KJ/- (jS7-<1.-~/
SEATS
New Construction 0
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 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 aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~uildmMevoke this p ~ ..:;~ca~s#urthermore, I hereby agree tha;5~:a9(;qs~ee may enter upon the property 10 pe%rm_ n~:d ~Pqtions.
Signature i Uoense No. Dete
Fireplace CI
Alterations LI
Septic 0
Addition 0
DeckCl
Finish Attic LI
Ae-roofing CI Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
JJdSDO ' ()()
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
IUD N1 ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~~
PILING LOGS 0
PLANS & SPECS CI
SURVEY Cl
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
TYPE OF CONSTIlUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought FOlWard .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
DMsion 1 2 3 4
Permit Fee .................. ......... .... .... 4:
lU.[~
I . ;}f:;
Plan Check Fee ............................. $
State Surcharge ............................. $.
Penalty ....................................... !t
Plumbing Permit Fee ....................... <;:
Mechanical Permit Fee .................. ... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & WaterPermil ...................... $
Gas Fireplace Permit ....................... $ Water Tap ................................... $
This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $
By Date Other ......................................... $
Certificate of Occupancy Total Due .............................. $ -[(f)eOO
Paid im _00 RaoeiP1NO,'-<'c::;tJ )'
Issued . . Y'"
Oat. fo-g-qq By ()...16.0
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 requ~. This OOcument wi"
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
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850
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