HomeMy WebLinkAboutBuilding Permit 99-0829
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
1.1. ~'9 '1
TIME
ADDRESS
15365 !:uJ?' /?t. ~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~If- 'gJ. 9
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION .~ 0 SEWER HOOKUP
~FINAL /Vl~~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
()/f\
A
('~ _~JIJ
,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CAll FOR REINSPECTION BEFORE COVERING
Inspector: /!'~ Owner/Contr:
CAll 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
o ?
INSNOTJ
_..n.__...._....___...__...__.___. ....'_n.___._. ___~,__.._.__~__ ~ ._._...._~_______..".
~~
1~R~1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicanl
Permit No.
97-r2.'1
,
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1. DATE
""II ~/'iq
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
2-
/C;3 "" <; F .<;/." Pi
2-
/'7A V~~ Z
1<0 "A
12. NO. OF STORIES
LOT
=\LOCK
PID '2~-~"y - 6/'1-0
ADDITION
,vD
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
<X:~N ~ :I~c.~
5. ARCHITECT
(Name)
(Address)
.... \J.. \(bw <; 1<'.1
(Address)
(Tel. No.) . f
Lt4-1- i.lO(..~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction LI
Re-roofing LI Porch LI
Re-siding [11.,..0oo- Finish Basement LI
nr't-I 5~t/d1
/'
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
kK;:,G k/f1-/P I
~/7-B
~/...Uf0~(/.r AVE'.
Fireplace LI
Alterations LI
SepticLl
Addition LI
DeckLl
Finish Attic LI
SEATS
16. PROJECT COSTNALUE
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS 1100 CULVERT SIZE
Width Depth Yes No
ve 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
rty and th I construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
this pe r st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform ~nspections.
E- n Je;;;)/';:O ~
License No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS LI PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~s r-Y/;r-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS D
SURVEY LI
SETS
COPIES
'2-n5U _ V'
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ...................... ............. $
7'-1.11
Plan Check Fee ............................. $
State Surcharge ............................. <t
I. '"l-V--
Penalty ...................... ................. $
Pressure Reducer .......................... $
Meter Horn .................... ............... $
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Plumbing Permit Fee ....................... .<t
Mechanical Permit Fee ..................... ot
Sewer & Water Permit ...................... !I:
~;:L"g!!Jtr~~~~I~i~~i:,;itW'ItPfl("7
~~ I /1
Certificate of Occu~ancy
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
other ......................................... $
Total Due .............................. $ ..,~ . ~
Paid -; b. (//) ReceiPt.~t _ ~'--I';'
Dale 7 / ~ / 'i ti By J:t.t^--
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoning1:>rdi~ance ~nd may pr~equested. 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.
CRy Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850