HomeMy WebLinkAboutBuilding Permit 99-0819
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUlED
'.t-.l-1~
ADDRESS SS!5f: ~ z;.-
OWNER CONTR.
PHONE NO.
PERMIT NO.
r7- 8/1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATI?~Af)
J!!{ FINAL """., \[]I
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADfFlLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/I"-PNV M:srd I ,~
. ,
~ 1
ell:
/" firu .t..JJ
gWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPEcTION BEFORE COVERING
Inspector:
/fl.A
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
6~1
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//1/1'9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99- N CJ
,
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
I-\-~~
2. SITE ADD~SS (\ - \ '\
~r::::. -:>It. ~t)~\U..kJOO~ \~\L w L
I
3. LEGAL DESCRIPiON
LOT
S/lNO
4ThN,t~ t\O~\<.:S.TW
ADDITION
BLOCK
17011\1"/
5. ARCHITECT
(Name)
6. BUILDER
(Name)
~\ql\i:-~,-\~\,(j9,
7. TYPE OF WORK
New Construction LJ
Fireplace 0
Alterations a
1, DATE
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
Pt/ .0
12. NO. OF STORIES
PID J-5-2./4- oor-o
. -:? ep
13. TYPE OF CONSTRUCTION
~~~t.~~l:l\\LLN~"'II...~)~L\:
14. FLOOR AREA APPORTIONMENT USE
(Address)
(TeL No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
\d.OO L 'l~~ Sl"
~~3-oo\~
OCCUPANTS
SEATS
Septic 0
Addition 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
16. ~OJECT COSTNALl::E:l
~?:00() -
17. COMPLETION DATE
Deck 0
Finish Attic 0
Chimney 0 Mlsc
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
t 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 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~~~.wo~rmit for just cause. Furthermore, I hereby agree that the city official or a d~~ ~~l\ upon the property to perfO~~\d~e~ons.
Sidhature license No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
LE.~~
TYPE OF CONSTRUCTION: I If 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 ...................... $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Bad<
SOIL TESTS
o
o ENERGY DATA
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2- nrv . cJi)
PLOT PLAN
o
s U
City:
Amount Brought Forward .................. $
Park Support Fee ................. .... ...... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7 '-/7_
I. "Z-\
Pressure Reducer .......................... $
Meter Horn .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
:t3S Rr.~iA::: .{~.;~~;I~I~~.;.~" W!;r/ip~.dr.
By "Jlf..,{" ie~JfA:... Dat. 1 / 'i '"7_
{ f '
Certificate of Occupa'ncy
Builder's Deposit ............................ $
Other ......................................... $
Total Du. .............................. $ '/ I" - (/U
Paid 7 (L - r/V Rec.ipt No. 3sr-'97
Dat. 7/,141 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zonind Ordihance 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.
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447.9850