HomeMy WebLinkAboutBuilding Permit 99-0792
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
_0 Ic?s-. 3'3 ()
ADDRESS
Ys2).')
CC/(fILldQ.:J-/ SE
OWNER
PHONE NO.
CONTR.
o FOOTING 0 PLUMBING RI 0 EXC/GRADIFILLING
o FRAMING 0 MECHANICAL 0 LKSHDRElWETLAND
o INSULATION 0 WATER HOOKUP 0 COMPLAINT
o FINAL 0 SEWER HOOKUP 0 SEPTIC FINAL
o FOUNDATION 0 SEPTIC INSTALL yO FlR~fE..- ILHo.#~;c.
o DEMOLITION 0 PLUMBING FINAL ~C::. c '" "-
o FIRE P'REV. 0 SITE INSPECTION
COMMENTS- iIP....:> ~ -e:>J .JJ, ..;l. _...~ ~
~0 ~J:; _d.- - _
-:7*0 ,(""~ ~A...Jr Wi.-,.._/UJD!l,j)
,.4;." ,J (~___ d"Ie..t7 ~ / ~ ~
' (/.-/
-n., ~ .,/..~_..;..,. .~
PERMIT NO.
9L? - 7L?;;J.
O~RK SATISFACTORY, PROCEED
,{ CORRECT ACTION AND PROCEED
o CORRECT~R A L FOR REINSPECTION BEFORE COVERING
Inspector:. Owner/Contr:
CALL 447 230 FOR THE NE; INSPECTION 24 HOURS IN ADVAN~E
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
-
~~
.QATI=Rr=r.l=lVI=I:l
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
CilY
Applicant
o -J447
Permit No. Cfl-71;;2..
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 18 ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
#'5t:!'J.s-
1. DATE
t-,;1~-?~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT Ai too I "l ;;; N). ';:).. BLOCK
~~ ~ ..sft:".
15"'
12. NO. OF STORIES
PID /If) -(XJ / - I;;) {-o
13. TYPE OF CONSTRUCTION
ADDITION
(Name)
(Address) M ~
I{S"OS- -<
(Address)
(Tel. No.)
4'17- y;:l./~
14. FLOOR AREA APPORTIONMENT USE
,4. OWNER )famel I /J ...L..
,4.d:> .-i...l)~
15. ARCHITECT
a:~~~~~
'. ,,,;~ OF WORK
New Construction 0
Chimney 0 Misc.
la. 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 owner or authorized agent for
the above mentioned property and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
building official~vo~hiS::2f:i~;styurthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed inspections.
X ~ ./.T. /h ~ -.;1<;/- 99-
.h~ UcenseNo Ollie
(Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
Septic 0
Addition 0
d:>B96't!hA ''1~
Deck 0 /
Finish Attic 0
OCCUPANTS
't'7'7- f'.:1 /.,:.
SEATS
Fireplace 0
Alterations 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLiCATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION . ::J <;'fYl. ao
SURVEY
PLOT PLAN
o COPIES
o
USE O)j BUILDING ,
l<st".,. A I R
I
TYPE OF CONSTRUCTION: I 11 III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ............................... .... $
Plan Check Fee ............................. $
R S U
Cny'
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7"LJ~
State Surcharge ............................. $
Penalty ....................................... $
\ .'2.S
Plumbing Permit Fee ....................... q:
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... :t
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ . ~ L.O
Tolal DUa()i2......................... L.Jft9.
Paid It,. /'. . Receipt No._ 1 ~S-
Date 0jj.,l-/- 1'1 By ()JIJ.L)
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 as reMested. 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.
Gas Fireplace Permit ....................... It
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850