HomeMy WebLinkAboutBuilding Permit 99-0831
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
IJ..- 3- ~ 'I
ADDRESS ///d. <;(j ~ {';A .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'17- 33/
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
..D~INSULATION .'/1 Jjf)D SEWER HOOKUP
~ FINAL .Ao -~\!V 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
- .
Uf'\
ch.P ~
.;.
~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/
INSNOTl
05
~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
;7;ii:;.
1. DATE
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
14-?- <;4 A....U c.re..I.... tJ6:
3. LEGAL DESCRIPTION
-P~.r It:..
""l-Ob - <("\
KI
..r,o.! ~':l-
LOT
ADDITION
II BLOCK 2- PID .?-5 -07<1 - 0;0 - D
III. ..sfjt)eE u/7,c ~ ..:s-eo
4. OWNER
{{ob~ f
5. ARCHITECT L
(Name)
c;..---J..M" C;c"....L.... \.e_....
(Name)
(Address)
.q':).C;4
(Address)
C(,..~t\!
A....L c..,..~
(Tel. No.)
", >- "ql-.- It(),J
(Tel. No.)
6. BUILDER
(Name) (Address) su,-\/::- (Tel. No.) lot>. gq~
CQ.O'7$ R":p I "<<'_c..,. "" $'60 {. Trow~~r"" ~" 51"
1.<)......'\.""S E 'i'lolt"'-CJ 1l-(.l.ru",v\..IIIl.-~~"';)'3"1
Fireplace 0 .. Septic 0 J Deck 0 Re-~ng 0 Porch 0
Alterations 0 Addition 0 Finish Anic 0 Re-sidinr Finish Basement 0
7. TYPE OF WORK
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -83 /
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
New Construction 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES \9. 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 tor
the above mentioned property and that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the
:uildlng/l:..al ca~ permit for just cause. Furthermo,e. I hereby ag'ee that fhe dty OffiCi~::;O is!-gge, gr upon the property to perto; :e:,: ~n.;,::"tions.
Signature license No. Date '
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS Ll ENERGY DATA Ll
OFF STREET PARKING PILING LOGS Ll PERCOLATION TESTS Ll
SPACES REO. PLANS & SPECS Ll SETS
SPACES ON PLAN SURVEY Ll COPIES
PERMIT VALUATION 2- s-m> ~ PLOT PLAN Ll
SETBACKS: Required
Actual
Amount Brought Forward .................. $
Park Support Fee ........................... ot
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... It
$
Fronl
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
,F!&S fr/.L-
I
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
7<f.l ~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.......................... ............. $
Plumbing Permit Fee ....................... $
~
f. 2;
Pressure Reducer .......................... 4'.
Meter Horn ................ .... ............... $
Water Meter ................................. ~
Sewer & Water Connection Fee ........... It
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ It
Other .............................. .... ....... $
Total Due .............................. $
Paid '1" . (/()
Date -11(, / q q By UA-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning brdin~nce ~nd may proceed af requested. This document when
rned by the City Planner constitutes a temporary Certiilcate of Zoning compliance and allows Coostruction to commence. Before occupancy. a eertifica'e of Occ\Jpancy must be issued.
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... ~
:i:F1Dt,ell . ifFp........~~;,~I:.;e~i~Wh rO)lpd.
~ D~ ~
. r .
Certificate of Occupancy
Issued
Receipt No.
35 &(X
CrtyPlanner
24 hour notice for all inspections 447-9850
Special Conditions n any
Dale