HomeMy WebLinkAboutBuilding Permit 99-0820
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDU!-ED /(J -/l?- '7'1 If, v:-
ADDRESS I~ f)() / ~ ~...I
OWNER CONTR.
PHONE NO. PERMIT NO. q CJ-g'Z,O
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
! FINAL 0 PLUMBING FINAL 0 GAS~E~ TST
o SITE INSPECTION 0 MECH FINAL , .~t
COMMENTS: ~ ~ ~~,
,
~~)
.........
-
.-
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S:::O~ECT Wg;~LL FOR REINS:~::/::~:FORE COVERING
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
s~,
DATE RECEIVED
'7// /1-1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3 Yellow
File
City
Applicant
Permit No.
q9 - e'VJ
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
12 \I:.\~a \
1. DATE
3. LEGAL DESCRIPTION
)
SIR-/IJ CJ
~~ 'u\~'L- 'W~
o
t-\-'\ <1
pwp
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCI<'
Po f ",;-r
PID ~5- 2f5-()8..f-D
13. TYPE OF CONSTRUCTION
4/$
4~w~\-)u.;\~a\lRu..'S~'h,'L-(\~SO\ ~-Lett~v\t~~
ADDITION
14. FlOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
(Name)
~\~\\T-~ ~\~ \~D "v'\<\~ ~ f~c..~..())l{'l
7. TYPE OF WORK Fireplace CI Septic a Deck 0 Re~rOOfin~ Porch 0
New Construction 0 Alterations LJ Addition a Finish Attic a Ae-siding LJ ish Basement LJ
Chimney 0 Mis"
Ie. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 n. nad ro rty; a 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
~U~CI n re i it fn~ iust cause. Furthermore, I hereby agree that tht)~~ 't\ ~ignee may enter upon the property to perf~ :ee:~. ~PqiOns.
Signature \ license No. Date
OCCUPANTS
SEATS
16. ~JI1~DOLU~
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
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.e C?T A/ L.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2-CDD. Ol)
PLOT PLAN
D
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. ~
Park Support Fee .... .... ................... It
SAC ......................................... $
Collective Street Fee ......... ........ ...... ~
Sewer Tap ................................... It
.
Permit Fee ........................... .... .... ~
7o./.()
Plan Check Fee ............................. $
State Surcharge ............................. <t
,. ?r--
This
By
Permit. ..................... $
es~g ~:,';;It;ht'~h7j
/ '
Certificate of Occupancy
Pressure Reducer .......................... $
Meter Ham .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... It
Builder's Deposit ............................ $
Other ......................................... <I:
Penally....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ........"........... .'t,
Sewer & Water Permit ...................... $
Total Due .............................. $ "7 (. . 0 c)
Pa;d '7". qV Rece;ptNo. :rn-Q'1
Issued
Date 1/, / f q By JfJfA-/
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance c:nd may proceed ~ r~uested. This document when
signed by the City Planner coostitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
C~y Planner
Dale
Special Conditions ~ any
24 hour notice for aU inspections 447.9850