HomeMy WebLinkAboutBuilding Permit #99-0733
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /b-/~-''7 A,V:-
ADDRESS /~<lj5d f~ ...I;L;
OWNER CONTR.
PHONE NO. PERMIT NO. 19 - 733
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
)gf FINAL 0 PLUMBING FINAL
10' SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ -//10
~~
C I~~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
J?IL-;
~~,
-~,
*.& 'J
./
--
-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ALL FOR REINSPECTION BEFORE COVERING
Inspector: 1:;1} . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
~\
nA TF RFr.FIVI='1
CITY OF PRIOR LAKE
_ BUILDING PERMIT,
mq()L\~'lUiI~ \ 4 :999 TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
1. DATE
(.p/l/qq
'P( LOV" LrLke.. elSj;)
14~?f)
PI j taf"YS SI-.
3. LEGAL DESCRIPTION
LOT HEn'fiS /N g"VNO.lSBLOCK
ADDITION
4. OWNER ~_ L;> (Name)
'_' I ,.... y- Rv- 0 j ':'-i' h
5. ARCHITECT (Name)
PID .zs.~930 - t'Jr. 4-- 0
(Addre~
/43:0 KWOeA5:'Sf-:
(Address)
(Tel. No.)
LJ%,-2IQQ
(Tel. No.)
6. BUILDER (Name)
m Id-~ T(mtJerooF
(Address)
7. TYPE OF WORK
New Construction CJ
(Tel. No.)
ICOI ~. CJi F-f 1Cd. &J/:J.BcB-
)\vn:Slf i lie, mn. ."i~~::3'7 J J L-/q
Septic CJ Deck 0 As-roofing J( Porch 0
Addition 0 Finish Attic 0 Rs.siding 0 Finish Basement 0
Fireplace 0
Alterations a
pu--rnu--
'fi'1(.,.CD 1.
2.
3.
While
Pink
Yellow
File
City
Applicant
Permit No.
qq-7_~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13:.. TYPE OF CON~TRUCTION
1f'(',lf rf.}: I y.p-\'"rY)~
14~ FLOOR AREA ~PPORTioNMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
lB. PROJECT COSTNAWE
CO)'1ICl,03
17. COMPLETION DATE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. 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 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 official ca~evoke this permit for ~t cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ,..~ Kc+u. ?nI4""::'i~L., ltJ/8/qQ
Signature License No. Dale
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2. 5l:J7) . cnJ
USE OF BUILDING
,e6.s ~/R
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOlATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Division 1 2 3 4
Permit Fee ...................... ............. $
Plan Check Fee ............................. $
State Surcharge ............................. <It
Amount Brought Forward .................. $
Park Support Fee ............. .............. $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer .......................... $
Meter Horn .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7f+;.6/V Receipt No. 35564-
Issued
Date 0/(~/'i'1 By /!~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~llCe and may proceed" ;equested. 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:
7d.7~
I. 2.~
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... t
Gas Fireplace Permit ....................... II:
~~i~/~~:t';'lt7.hi/~t!/q
Certificate of Occupancy
City Planner
Dale
Special Conditions if any
24 hour notice tor all inspections 447-9850
$
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