HomeMy WebLinkAboutBuilding Permit 99-0722
DATE TIME
CITY OF PRIOR LAKE A,~
INSPECTION NOTICE SCIjEDULED /tJ-Ij>- '?'t
ADDRESS /~ d.h& ~. r1~
OWNER CONTR.
PHONE NO. PERMIT NO. 99- ?~
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
COMMENTS: ~..J (/h
(6~ - ?~'Y
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o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL ~ ~
~~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:s:e:::.ECT; CALL FOR REIN::~e::::n:rEFORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
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I.,'."
,.t' CITY OF PRIOR LAKE
BUILDING PERMIT,
"FEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
QA TJ:" RJ:"r.J:"IYEQ.
~//-I/91
DIAECTlONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
jl.jJ.j'(7
3. LEGAL DESCRIPTION
J3
Sri/'! 0
1. DATE
o -jtl-9,
Jhf)rQ Lv
/lib
pup
LOT
PID 76-2/.5'- tJ.57-()
Pr ~ Ar2PA/
/' fl (Address)
\.1. II.Pt1hN JiriIJ, Sfw.t L.I Kr
(Address)
BLOCK
4-
ADDITION
4. OWNER
(Name), f
All A 10
-
(Name)
(Tel. No.)
'-ILfJ- I '). Y D
5. ARCHITECT
(Tel. No.)
6. BUILDER (Name)
N ~1t51rlAe{idli
(Address)
(Tel. No.)
bfJo't<{r-7!'i'(
113 Err fel/Ullt, sf
'l-O~,\. MI\( 'i nOf
Septic CI Deck CI
Addition CI Finish Attic D
~
Ae-rooflng Porch CI
Re-sldmg CI Ish Basement D
7. TYPE OF WORK
New Construction a
Chimney CJ Misc.
Fireplace 0
Alterations a
1. White
2. Pink
3. Yellow
File
City
Applicanl
Permit NO...!l.,Q - 7 /~ ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building officia~~e thiS. If;[rmit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x'L--~ ~ .!2.0/(; 4pO d- V-/q-q'1
<-s;6nature license No. Date
MATERIAL FILED WITH APPlICA nON
Back Side Side SOIL TESTS Cl ENERGY DATA Cl
OFF STREET PARKING PILING LOGS Cl PERCOLATION TESTS Cl
SPACES REO PLANS & SPECS Cl SETS
SPACES ON PLAN SURVEY Cl COPIES
PERMIT VALUATION ..2 s."""VU _ Cf'--' PLOT PLAN Cl
Amount Brought Forward .................. $
Par1<SupportFee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................ ................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Permit ...................... $ W t T F $
Gas a er ower ee ...........................
~~s~:7"~iy..~...........n.g..;..:$';'.~he"'II>p~'J.,,.f Water Tap ................................... $
\.>J '~~7'" ~ II _[!l_ Builder's Deposit ............................ $
cel'litiC8\87 , I Other ......................................... $ --7, 00
Total Doe .............................. $ "" .
Issued __"I Paid '(D.()1J Receipt No. 3S<lW
1"\siS\Oce<'i~ Dale t.//'fjt;q By t=
signed 'o'j ~ ~ the above application and accompanying documents is in accordance with the City Zonin6 Ordinance and may pr~ requested. This document when
___ ~ a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate f Occupancy must be issued.
r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/&efR/~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee .................. ............. .... $
7'-1.'71
Plan Check Fee ............................. $:
State Surcharge ............................. $
I.z...r
Penalty ....................................... $
'1umbing Permit Fee ....................... $
'anical Permit Fee ..................... $
se
Date
Special Conditions ff any
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24 hour notice for all inspections 447-9850
17. COMPLETION DATE