HomeMy WebLinkAboutBuilding Permit 99-0806
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
1"-/'1-'j')
.4.7;
ADDRESS j,~ (. 4/3
rrtd:tiJP ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: ~PrYI ~
I
??- 8ao
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
)lI< -1k..J
~~
C (If /"r<ZQ
-
.:;L~ ~)
, ./
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~CALL FOR REINSPECTION BEFORE COVERING
Inspector: '{3::).- , Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(~_lV
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F~te
cIty
A!pplican{
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l~'White
2. Pink
3. Yellow
Permit No.
qq- PJOfo
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
/!5~~g 5 E.. I1/TC-I-fE-I._L CII2e-L--6 ~/Sj;)
\\'1,.,_\qr(\nd~r)9\ R}vd.
7. TYPE OF WORK Fireplace CJ Septic CJ Deck Ij Re-roofingA Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement 0
ChimneyLl Misc. ---rou...- cS\.-/. ~ ~0\.CUO.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby ce . have fumished informatio 0 his application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for
th e mentioned p erty and that all co truc 'on will conform to all existing state and local laws and will proceed in accordance with submined plans. I am aware that the
X ilding official n rev~ this ~~it :r jus au . Furthe::e, I hereby agree that the c~(; \' ~s~:-;,aanter upon the property to pertoc:.le;,e~sfec~:;,.
"",00 Signatur~ ~ License No. ~ 1 Date ~
3. LEGAL DESCRIPTION
/'0
1"117C!H~t.,L,
LOT
BLOCK
ADDITION
4. OW~R ,,(Name\ . . .
'~\.H'lll\ NX ~ )\..",
5. ARCHITECT (Name)
6. BUILDER
(Name)
AAArv\<<l.f~b ~ In(l
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
lee S Ale...
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .................. ................. $
Plan Check Fee ............. ................ $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
2-
POI.!/J
15~)~ ~ .6. V\\..h\d\eIN~h{OJ..,G/'l
(Address) (Tel. No.)
PID .2E-1."i.5- OZO-o
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
/.c1l_0l00
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
SOIL TESTS
Ll
o ENERGY DATA
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
COPIES
SURVEY Ll
2 ::=>u (/. d'l;;
PLOT PLAN
Ll
s U
City:
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC .......................................,. $
Collective Street Fee ....................... $
Sewer Tap ................................... $
74.7(""
/. z. r
$
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
This
By
Total Due .......................,...... $ ""7(",0 ()
Paid 7(,.0 0 Recei~~.'l'.il ~H5g .3
Date vi"?? If1 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordi~ance and may procee~quested. 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.
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447.9850