HomeMy WebLinkAboutBuilding Permit 99-0732
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
5'6.5 0
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATI?~ Ai\
III FINAL /"'^' 0 \0/
o SITE INSPECTION
COMMENTS:
DATE TIME
SCH.EDUL~P (J.. -02 - ?f
~ 51: #.f
CONTR.
PERMIT NO.
?o/- 73,:;)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ ~/~ ~d1!~n
1)/1
r ~ {{J!;
\:!<wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _
/JL-tA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTJ
f1lC1~J.\P i 4
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j.::JJ-...J
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~vntt. (b'~White
S~1
DATE RECEIVED
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99- '232-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
(P/1/C19
2 SITE~~~S 0 C. ~fi\arwm;O. St - N r
3. LEGAL DESCRIPTION
'PUD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
/
'sI'iND Po/NTE
4. OWNER (N.me)
'\Vrf,J)r10\ --(, (fA {(\O<;
5. ARCHITECT (Name)
BLOCK
I
5TIt
(Address)
St~c.edtl(Wjlrti S\- . NT.
(Address)
PID ~?':=:;-7~.,.,q- n()/-O
LOT
(Tel. No.)
40'b. bDlolP
(Tel. No.)
-rearoofrrfero if
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTc:.
l\A l ct V\l e.H-h tyl.,pea:1l5T
7. TYPE OF WORK Fireplace 0 Septic 0
New Construction 0 Alterations 0 Addition 0
IQdt{J-r{f~ (hfll ~Dg' tifl-
Ae-roofing ~ Porch 0
Re-siding 0 Finish Basement LJ
SEATS
OeckC'l
Finish Attic Ll
16~\i2 C~~LUE
17. COMPLETION OJ-.. TE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that' have furnished infonnation 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 10 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a des~ee may enter upon the property to pertorm needed inspections.
X ,)tAr..cu.-I.\~ ~f")hr -;:}.()lL.n:\~\O (f}/r{"q
SlgIlature License No. ate
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION -.----2~).dU
,
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
USEOFBUILDING ~t=;S "q,//Z....
SURVEY 0
COPIES
PLOT PLAN 0
TYPE OF CONSTRUCTION: I II HI IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .................. ......... .... .... ~
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .... ...... $
Sewer Tap ................................... $
$
7t/."'7S
Plan Check Fee ............................. <t
State Surcharge ............................. <I:
J.z.-:>
Penalty ....................................... ~
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee .................. ... $
Pressure Reducer .......................... $
Meter Horn ....... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
G.iPlft;,~................. $
This n s vJJOOilding Permit when;?prot4'
By "'77~ D,'e (p. {~ 1
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ !I:
Other ...................... .... .... ........... $
Tot.1 Due .............................. $ '(A.ov
P.id 1(0. (,() R.ceipt No. .3 5 S 04-
~ued !
D.te b rs/tjq 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 - requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certnicate f Occupancy must be issued.
City Planner
Dale
Special Cond~ions W any
24 hour notice for all inspections 447.9850