HomeMy WebLinkAboutBuilding Permit 99-0748
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SC~EDULEO
DATE TIME
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ADDRESS
~Z34- &eCO/'T ~/I/e::lZ- eo.
PHONE NO.
CONTR.
PERMIT NO. qq.!.... , 7L/8
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.Ji('FINAL JI!.Q(J,t::
'/0- SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: (iJ /~ ;-- ~ - '. JJ ,~rd....' ~d:..
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- LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT '!JI!K. CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
gALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DA TF RFr.FIVE.Q
CITY Or PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
CiIY
Applicanl
~/'1i11
Permit No.
99 -7L10
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
,<):;7.~/..1 nt-pAIr /l1J/el?
1. DATE
~/17 /91
~d ~/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Widlh) (Depth)
3. LEGAL DESCRIPTION
LOT 4- BLOCK /
~I?() (,)J::.~V ILLE;
12. NO. OF STORIES
PID '7 ~,? /.,(') - OCJ.f--1?
ADDITION
4/T1-I
13. TYPE OF CONSTRUCTION
4. OWNER
I~mj
5. ARCHIT~CT
(Name)
AI/pi <~ J{/
(Name)
(Address)
5~M.p_
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
I
(Te~~.k. ~'f-.311? 15. NUMBER OF OCCUPANTS OR SEATS
)/ d-J.. III ~ Ill'" ,050/'1 OCCUPANT~
UIY(e'(1/;N.'-;~.1:N(". /JD/../ R/J/e~~ t:>-e, ~IIL~.....A1U SEATS
7. TYPE OF WORK Fireplace 0 . Septic 0 Deck LJ Rs-roofing 8--' Porch 0
New Construction 0 Alterations 0 Addition a Finish Attic 0 Re-siding CI Finish Basement 0 16. PROJffT COSTNALUE
Chimney 0 Misc. f1 '"'7{ I ?o ~
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Ves No {) -/7-9 9
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 confOIm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offJg!al "revokej1is permitjf just CjLJ6.e. Fu~ore, I hereby agree that the city official or a designee may enter upon the property 10 perform needed inspections.
x_;:::"'.-H4444 L ~ .::J0QL29;;1tll _h-n-t!l-
-t.. . Sigiialure . - License No. - Date
6. BUILDER
(Name)
(Address)
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGV DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS Ll SETS
SURVEV Ll COPIES
PLOT PLAN Ll
BUILDING DEPARTMENTVALUATJON
USE OF BUILDING
R.ES /t/~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION .:;)SfJ/? rfr)
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H r M R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
74.7-=>
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ............................... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/. z..r
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ................ ................... 'I:.
Water Meter ................................. 'I:.
Sewer & Water Connection Fee ........... <t
WaterTowerFee ........................... <t
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ It
Other .........................................,It:
TolalDue .............................. $ '7(;, .00
Paid 7~. 07) ReceiPt'~ ~-S7 ~
Issued ~
This is to ce<lify that the 'OQuest in the above application and accompanying documents is in accordance with the c:=oni~ ~ni ':lay pr~ "",uesled. 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.
llding Permit Whe~~ro?;.. ill
Date (,,//7/ <t~,-
C~yPlanner
Date
Special Conditions if any
24 hour notice for aU inspections 447-9850