HomeMy WebLinkAboutBuilding Permit 99-0779
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDU!~ED
DATE TIME
1'0-r9-" A, T;
ADDRESS
/5~,;L1 4/~ / 4ve I
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
5FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
R-/~
I
t9-7?9
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
ft G~IR TST
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/ (I/~
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...../
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: tq , Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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pm'R.r..'VEll CITY OF PRIOR LAKE
r 0 r,{3/1'j' BUILDING PERMIT, ~J71
710. 0 '/~ f TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
1. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
q9-77L
New Construction 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. c:: Width Depth Yes No
I hereby certify t t I have furnished i ormation 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 men ned property and t t 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 0 ici ca~~)~ t for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the proie~ to perlorm neede9' insp9C}ions.
X . A . r -z.aL6'L2:i:-'f. ~ f~.",. '...-":.' ~ / /7'/9Q
~ -.. signatur( License No. Date ..
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
!3EFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12.SITEADD~~~,.:)/ <:--5P'u//-n., A,~ JJw
6- /7-9 9
/<ISD
3. LEGAL DESCRIPTION
/4
/SLFlNO
LOT
BLOCK 3
VIew
PID 2G -/<<3 - 653-D
1ST
ADDITION
4. OWNER
.:laP.
5. ARCHITECT
(Name)
01'1\'
(Name)
(Address) _
/S6;;1/ ...sJ:.<.(/u,~ AvolfA)
(Address)
(Tel. No.) I
tJ;/d-<N7-~
(Tel. No.) ,l
6. BUILDER
(Name)
(Address) .j'. l1AI (Tel. No.)
,(3VH7JVI ,-" I '7 il'/J..)
~q7J\/'()o.l&l~.l 5S33? 7ra.:-&9Sct_
Fireplace u Septic 0 ueck 0 Re-roofing.CV"" Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding CJ Finish Basement 0
At3C!
7. TYPE OF WORK
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
,..:}/"> <\1'"'1 ~
'to-
12. NO. OF STORIES
~
13. TYPE OF CONSTRUC}teN
k3? ('nOr-
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALU~
~-~
17. COZ/:;~;q ~
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
Side
Side
USE OF BUILDING
LES ,q-/It"..
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
'Z rTV , crv
,
TYPE OF CONSTRUCTION: r II III IV V
OccupancyGroup A B E F HIM R S U
SOIL TESTS
D ENERGY DATA
LI
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
LI
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee .... ......................... $
State$urcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Amount Brought Forward .................. ,It.
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
City:
747S
I. z..r
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~ili;~~~~;I~i~~~:t;it~ttPJf~
I/o , I
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7". (rP
Paid /&;. c/l/ Receipt ~q. .3: 5~> 1
Issued I I ~
Date b/2- 'l /1('1 By /1"
ThiS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City Zomng 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 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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