HomeMy WebLinkAboutBuilding Permit 99-0731
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 3 Z ~9
DATE TIME
I~ -2-2-'t7' A)";
+__. _U T~.
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
J>I FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: R.,v/ . "
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99- 73!
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
}5-- ~
~""\
./
-
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INS/VOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
,.."o_'-y-
8~~
DATE RECEIVED
4
!y\ q()SoZ-
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMlT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS 32BCJ
~nY\ff ~ l 1.0. CO
1. White
2. Pink
3 Yellow
File
City
Applicant
1. DATE
Permit No._C/t:J-73 L
101,/gCj
~1('Qmare TrcU...Q
3. LEGAL DESCRIPTION
LOT 1'11":71':.'" /N /3iJVNLl"5 BLOCK
ADDITION
4. OWNER \...... (Name)
, )( tln 'P{\Yrlnyrj
5. ARCHITECT (Name)
6. BUILDER (Name)
midwe::,t- C'edCV
Tlm~ooF
7. TYPE OF WORK
New Construction D
Fireplace 0
Alterations D
PID ~!5-/0r",- OOq-(')
(Address)
~7.Aq ,~amO'le Tr-o...d
(Address)
(Tel. No.)
440.~(.,t-/
(Tel. No.)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIEf oJ- Z
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
~ 106. B6
17. COMPLETION DATE
Chimney LJ Misc.
18. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Sq. Fl. 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 aJso 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 Jaws and will proceed in accordance with submitted plans. I am aware that the
building Officitj revoke tho is permj~ lor ju~~se. Furthermore, J hereby agree that the city of~al or a deSign.ee may enter upon the property to perform needed inspections.
X ()Lq-\q 0_ I<C'.hf dOILli33(.,. (Dn iCfg
D Signature License No. , Oat
(Address)
ICOI fC.~,fl' Qd.
furnsvdlt',mn 55~31
Re-roofing)( Porch LJ
Re-siding LJ Finish Basement LJ
(Tel. No.)
GIZ-g'C,8'-I/4Q
Septic LI
Addition LI
DeckLl
Finish Attic 0
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
R.6S A / Je..
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ........................... .... .... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
PJumbing Permit Fee ....................... $
Mechanical Permit Fee ............. ........ $
Sewer & Water Permit ...................... $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
. PILING LOGS 0 PERCOLATION TESTS 0
OFF STREET PARKING
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPJES
PERMIT V ALUA TION Z::::;,VU.cJV PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
S U
City:
74.7~
I. z.E'"
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $
~iS,;JJ1::trl.. BuUdlng ;;-:" ti/'~t41
~ A f~ f /
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ '7t.. 0 0
Paid '7 (, .0 0 Receipt No. 3::550L/
Issued . ~
Date (, //(5'/ t:!f C; By
This is 10 certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce and may proceed requested. 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.
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850
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