HomeMy WebLinkAboutBuilding Permit 99-0834
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUI-EO
DATE TIME
ICl-3--91
ADDRESS
5 76:1 P~,A.O S.E.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
77-:? 3'1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION /Jl)
,l! FINAL A;,d vy
o SITE INSPECT/6N
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
oj;
\
~~
v
'-
~RK 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/
INSNOTI
~7E;7qq .
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
t. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
q CJ ~ !..34-
I 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
69L. fiT R.tJ,f,r!p Au ;rE.
3. LEGAL DESCRIPTION
LOT
/3
(J/l1C
BLOCK
If!:IOt5E
14. OWNER (Name)
15. ARCHITIjrI tf (Na;:d r-
6. BUilDER (Name)
ADDITION
I/+cd 5
/!oo+: '11
7. TYPE OF WORK
New Construction C1
Fireplace 0
Alterations C1
Septic (]
Addition 0
1. DATE
7-1-'1<)
.leI S.D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
/
c;r
PID 26-1J1J3- tJJ3 -0
/sr
13. TYPE OF CONSTRUCTION
(~SS!
-t'R ,0 ~
(Address)
(Tel. No.)
1</1-(,,2. .1./
14. flOOR AREA APPORTIONMENT USE
l-#k
(Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
::r oe.J".. N
,
,ffl.,IV
19~-,J737
SEATS
16. PROJECT COSTNALUE
Deck Q
Finish Attic 0
Re-roof~ Porch 0
Re-siding 0 Finish Basement 0
Chimney 0 MIS/'"
18. PROPERTY AREA OR ACRES 19. 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 1 am the owner or authorized agent for
the above mentioned property and that aU construction will conform to all existing state and locallaw$ and will proceed in accordance with submitted plans. I am aware that the
building off>>1 can rev9!<E!. tl}l9lermiypr just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed insPitCtlons.
X fidlrAJ/ n~ 9/~ /!- 7- 97
Signature license No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
RIS3' 1/ L
17. COMPLETION DATE:
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS Ll ENERGY DATA Ll
Side
Side
OFF STREET PARKING PILING LOGS Ll PERCOLATION TESTS Ll
SPACES REO. PLANS & SPECS Ll SETS
SPACES ON PLAN SURVEY Ll COPIES
PERMIT VALUATION ~~. vV PLOT PLAN Ll
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Permit Fee ..........~~i~~..~...~...~..~... $ 74. 7'>
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City,
Amount Brought Forward .................. $
ParkSupportFee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
/. Z.S
Pressure Reducer .......................... $
Meter Horn ........................ ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
..m......mm..m. $
Building ~:'':' w~;'h'i'IJ1'
f .
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .......m..m............... $---21.. .aD
Paid "1'. () 0 Receipt Np. 3S r. '2 2-
Issued . -
Date 7 q BY~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin Ordinanc and may proceed uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate f Occupancy must be issued.
Thi
By
CnyPlanner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850