HomeMy WebLinkAboutBuilding Permit 99-0856
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDl~_ED
DATE TIME
I/J-/i'-'J'j
A.,~
ADDRESS / ~ ~ '/6
~ ~ //Z. IJp.
OWNER
CONTR.
PHONE NO,
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING @J 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
A FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: ~
o
~
(
/re/~
~
-
'J'j-?'Sc,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~./
~
--
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, Owner/Contr:
. /
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSlVOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATI=; I=IFr.FI~/Fn
7/ q (q;::;
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
-7~6-1~
',;5J1~
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq - i"57P
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12 SITE ADDRESS I ~ 470 PIke.. L~ r~ 1(G\.'1
j(
C4S0
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID 25-923 - 0 (3-0
ADDITION /'7=, ~ /A/ 'faIhJDS
14. OWNER,"\, (Name) I (Address) I
o ().(\;Q. U"Jskao e 1"1,11'70 fi~ LC1h: 1fC4: .
15. ARCHITECT (Name)
6. XUILOER (Nam,e\
tI,I",U ;(J^", jJ",: (01:") CD"Jro.(.ft,,-5
(Tel. No.)
13. TYPE OF CONST~UCTION
(u"OOf
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Address) '/-' I. ,.
1'-'1..47 /I;ce,llI.-!-fIV(. ),
g'",IMVillL 501"')
(Tel. No.) "
7o?-6C,s.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace ["']
Alterations ["']
Septic["']
Addition 0
Oeck["']
Finish Attic 0
Re-roofing ~ Porch ["']
Re-siding a Finish Basement 0
SEATS
New Construction 0
Chimney 0 Misc.
lB. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS l' O. CULVERT SIZE
Sq. Ft. b I Width Depth Yes No
I hereby certify that' 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
building I o~ial ca.9'ywoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X K~-;<:-f" "LO,-,;c,~n _7-~-'13
Signature License No. Date -
16. P~OJECT COSTNALUE
., ,'7... ,-r.--O()-
17. COMPL~TION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
USE OF BUILDING
,e&$ ,.. / It.-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
z Fr-p rV'
PLANS & SPECS LJ
SURVEY LJ
PLOT PLAN LJ
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
City,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
7<1. '7.r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
1.2-5
Plumbing Permit Fee ....................... g;
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & WalerPermit ...................... g;
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ '7 &'.QV
Paid /~.dV Receipt N9. . ~lOf"dL
Date 7/ 'i/tf '1 BY-lf.t.-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin~ Ordinance and may proceed is 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.
Permit. ..................... $
uildlng ~:,,:n '71 'f~lf'
{ I
Thi
By
Issued
City Planner
Date
Special Conditions it any
24 hour notice for all inspections 447-9850