HomeMy WebLinkAboutBuilding Permit 99-0720
DATE TIME
CITY OF PRIOR LAKE q -,;/!-'1,} AIT;
INSPECTION NOTICE SCHEDULE;.D
ADDRESS 631l'1 ~ ~.
OWNER CONTR.
PHONE NO. PERMIT NO. 99- J~()
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION (]) o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GAS LINE AIR TST
~ SITE INSPECT o MECH FINAL 0
COMMENTS: ~.
Ifrrt ,-'<"> -( ~~
~ <J:]p~
/
LRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W'fK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ /. Owner/Contr:
CALL 447-98~A F~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~~
QATF RFi:Fll'I=Q
t//4/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
ApplicaDt
1. DATE
Permit No.
99-72--d
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
6 ~I L(.. C( <J
Rct1 .e/S..D
~J~ ADDRESS ~ ~ S-- /
#1t? /'1./ d'/t'
3. LEGAL DESCRIPTION
::;-
L/I 1::-6-..1"/ Pc. ~/11V()1'2-
J' / (Address)
-MdstJ.r1 /)3 y/
(Address)
LOT
/
PID
Z.-;-.P70 - OO(,,~O
~LOCK
ADDITION
I
Jy, (Tel. No.) I
IF/im4 j?<f' 1/#7-6N~
I
4. OWNER
.A . (Neme)
J'VOrt?t
5. ARCHITECT
(Name)
(Tet. No.)
6. BUILDER pi (Neme) j /
Ii ~""""r ~ai';I'u/"'?T
7. TYPE OF WORK
New Construction Q'
(Address) I> / (Tel No.)
7'7 tiS- V'lfe-8T# y%
p~ t//7-2~rG
Septic Q' Deck Q' Re-roofingp..---porch 0'
Addition Q' Finish Attic Q' Re-siding Q' Finish Basement 0'
Fireplace 0'
Alterations 0'
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
11 O. CULVERT SIZE
Yes No
BUILDING INFORMA liON
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. ~ OF CONSTRUCTION
ffr/Z ~
~
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATO
16. PRO~~~U"--
17'JM:I)O~ 9TE 9
the above mentioned prope~ ~~t all
~Ui:ldjng official can revoke thi~__. for j
/ Signaturef
I hereby certify that I have fumished information on is application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
o cti n will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~'!fI!JSJ.re, I hereby agree that lIle c;; oi~'liSj7~ ger upon the property to perform needed inspections.
;. License No. Date
-. -...-
-"- ,"_
FOR ADMINISTRATIVE USE
Amount Brought FOlW8rd .................. Ci::
Park Support Fee ..................... ...... 'to
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom... .... .... ................. ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... 4:
WaterTowerFee ........................... $
SETBACKS: Required
Actual
Front
"d<
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
?- S"'T"V .VV
USE OF BUILDING
,t!:C s;
R/./C
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
City:
"1 t-/. 'l.s-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
/.2.-r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
;llj/kl;;(A;,~;:t;~1;nhP(flrjq
/-----t"'" I I
Certificate of Occupancy
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0' PERCOLATION TESTS 0'
PLANS & SPECS 0
SURVEY tI
SETS
COPIES
PLOT PLAN
"
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 76,tJ 0
Peid '1 r. . GIV Receipt N,o.. :3!' t/ If 'Z.
Date ~!i"'/fj1 By ~
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 ~uested. 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.
Issued
CityPJanner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850
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