HomeMy WebLinkAboutBuilding Permit 99-0754
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DATE
TIME
A. ....
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL~D
7-z~-'TI.
ADDRESS / (~ '7 q (~
OWNER
AfJN A TJe....
CONTR.
PHONE NO.
PERMIT NO.
qq- ")54
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
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
COMMENTS: eOF
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V~K SATISFACTORY, PROCEED
~~~RECT ACTION AND PROCEED
o CORRECT lJ'~RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: . D"V Owner/Contr:
CALL ~7\850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSlWTl
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DATE RECEIVED
C?/17/Q.7
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 PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS I S
!/n"l?,(o AV\V\o.. ~Oti ~ . '2,
3. LEGAL DESCRIPTION
1. DATE
te -/l-'ft
/ZI
New Construction LI
Chimney LI Misc.
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished infonnation on this application which is to the best of my knowledge true and correct. I also certify that I am the ow~er or authorized agent for
the above mentioned property and that all construction will confonn to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding offic' n re this pennit for' u. urthenn~ 7agree that~() Jffi~0;;l47 7 enter upon the property to perto::; ~~j7n,ftions.
License No. Date (
BLOCK
LOT
ADDITION
42:WhE;1 nai t~(Y\i \ 't--
5. ARCHITECT (Name)
(Name)
tvs~~{KeQ~
6. BUILDER
7. TYPE OF WORK
Fireplace LI
Alterations LI
PID .;?-5-012.- 003-0
JAddress)
'u4 vYV
(Address)
&/t440 15.4 7
(Tel. No.)
(Address) II (Tel. N~
1'500 E-Clj~(2J iFrZ 70777'12.
g l Jv () .c,\J i I [€(\1 NSS53 7
Septic Q Dedk [, Re-ro~ Porch LI
Addition LI Finish Attic LI Re-siding LI Finish Basement LI
SETBACKS: Requir.d
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
i2r;s .rl / /Z...
TYPE OF CONSTRUCTION: I 11 III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ............................... .... C!:
Plan Check Fee ............................. ~
State Surcharge ............................. C!:
Penalty ....................................... $
Plumbing Pennlt Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & WaterPennlt ...................... $
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Cl ti - --;64-
,
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
17. COMPLETION DATE
7 dO\.v S
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .............. $
Sewer Tap ................................... $
$
Back
Side
Side
SOIL TESTS
LI ENERGY DATA
o
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2-~.CIV
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
S U
7';' 1 ~
City:
PLOT PLAN
o
I. z.s-'"
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... ~
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1(,. (/{) Receipt No.
Dat. (,//7/17 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordihance and may proceeds 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.
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ce~ificate of cxLpancy
Issued
City Planner
Date
Special Conditions n any
24 hour notice for aU inspections 447-9850
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