HomeMy WebLinkAboutBuilding Permit 99-0707
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCW<DULED
~
/0-19 -'79
A,I;
ADDRESS
ISS/{) U ~ ~ 0,
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'l!CFINAL
10 SITE INSPECTION
COMMENTS: ~
,
CONTR.
PERMIT NO.
9 <J -?CJ 7
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 GAS2J.N~R TST
o MECH FINAL }t ~ tI
~/~~
-
~ ----
/ / {lhf-<..A..
l
'-
~
+,~
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~, CAll 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/
... -.,'-'---
INSNOTl
--_.-.__._--~-- ,-. -.._.__._~--_._..__._.._----_._---~----_.__._._-
&~1;
DATE RECElVP1
b-({) -r;~-
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.
!14 -101
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
/5510 IZul OCL/L td
1. DATE
~//O/99
I
12/5D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heigh!) (Width) (Depth)
ADDITION
3. LEGAL DESCRIPTION
LOT /2 .. N'.Ii. DF /I BLOCK
R/?() OI'1"ICS
...,...-L (Name) (M,Sirassl
/ nei it tJ 155) 0 t.lA DfA.-t. td
(Address)
12. NO. OF STORIES
PID
25- 01./-2...- (JDt,,-()
13. TYPE OF CONSTRUCTION
" OWNER
~rw.. t
5. ARCHITECT
(Name)
(Tel. No.)
Ut./7-6/P5"3
(Tel. No.1
14. FLOOR AREA APPORTIONMENT USE
6T'etlILllER c.o.,f. "{Ill_)..-
(Address)
(Tel. No.)
J /)~N UJ> ((c. [b,yJ
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Septic 0
Addition 0
If!/OtJa'/(b.j Ttsi.t1u15.
Deck 0
l{t1hf104
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES
Sq. Ft.
16. PROJECT COSTNALUE
/5 .JIJ5~1$J
17. COMPLETIOI'II DATE
fr,-(Q-q'1
I hereby certify that I have furnished information on this application which is to the best 01 my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
'f''1'g ~ c:.;a~ITTIit 10' jusl cause. Furtha,mme, I he,eby ageee Ihat the clly 0");. m lis1J:J:;"'3 enta' upon the pmparty to pertz,7';1q1spectlons.
~ Signature UcenseNo.' I Date
Finish Attic 0
Re-roofing}l Porch 0
Re-siding 0 Finish Basement 0
SEATS
19. PROPERTY DIMENSIONS
Width Depth
11 O. CULVERT SIZE
Yes No
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
- BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~ oc, R!l<-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION _
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
0f$:0 .CD
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ...................... ............. $
V
R S U
ILj,1S
( . dc'
City:
Amount Brought Forward ...................'t
Park Support Fee ........ ...... ............. ~
SAC ................""......"........"... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
WaterMetar ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
:Gya,S~FirePlace Pennit .1ess~:iJ:.I.d"..n.g..;.a.e,~e '.I~e'>"..p~p,c/v.~ Water Tap ................................... $
ie~J/..Jt{ '''' / j I~ Builder's Deposi! ............................ $
Other .......................... .... ........... $
Certificate of Occ'/"ncy Paid T1abuW....".........~~:~I~;~0$~ ~
Issued .
This is to certify thaI the request In the above application and accompanying documents is in accoedance with the c~:;on~ ~?n~ a: may P'::'d ~~d) This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows COflstruction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850
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