HomeMy WebLinkAboutBuilding Permit 99-0859
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/56,;;..9
UJIL DuJlJOD ~/IC.,
OWNER
DATE TIME
/d-I'I-<j'1 A,'/:
PHONE NO.
CONTR.
PERMIT NO. S3...::. rr f=:, <]
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING(@) 0 WATER HOOKUP
o INSULATI 0 SEWER HOOKUP
E' FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: i2mr1,
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'-.. - ..--"
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
d~
4KSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wo;t<' CALL FOR REINSPECTION BEFORE COVERING
Inspector: m , Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bonom)
2. SITE ADDRESS
If5fO;J.9
3. LEGAL DESCRIPT~N
LOT I.f-
Permit No.
99 - %91_
1. DATE
l./Ltl#LA.i7J'TO C~~ I (l
3
f(tuJ
;z- 1.;2. '9P
/C-{
BUILDING INFORMATION
11. SIZE OF STRUeT ~H~
(Heigtlt) (Width) (Depth)
~LOCK
. PID 2-~ - 0 (f - 0 f '1---()
12. NO. OF STORIES
ADDITION
/").4K".W 00 r"?
~mel
h/lslf Ck
(Name)
13. TYPE OF CONSTRUCTION
4. OWNER
frv1
5. ARCHITECT
(Address)
SIg me.
(Address)
. (Tel. No.)
~- Y'~d'",..p
(Tel. No.)
'I 14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name) (Address) (Tel. No.)
'-J-..~ .'/,,, ,X.."" ",II A :!6.fT) 0. "S0'ItfJAfl) {.~~
, rfAI"-X-. , -'l ~(../ ~M Sf: . '7'~ 3f'l~
7. TYPE OF WORK Fireplace LI Septic 0 Deck Ll Re.roofjn~ Porch LI
New Construction 0 Alterations (] Addition 0 Finish Attic CI Ae-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the beSl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official CAn revoke 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 --;rnik2?!r;~UJ"A_../ . '7-/,;:}-t?:;
Signature License No. Date _
15. NUMBER OF O....:t:UPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
- ----
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
"oJ<
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGV DATA 0
PILING LOGS 0 PERCOLA nON TESTS 0
PLANS & SPECS 0 SETS
SURVEV 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
tt:.es "1L.
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
2..<ClJ1) . VL
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
V
R S U
14.7 r
City:
Amount Brought Forward .................. oj:
Park Support Fee ........................... II::
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ...................................)t
$
/.z..l
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
This Builder's Deposit ............................ $
By other ......................................... $
Total Due .............................. $ 76 - cru
Pa,d ~. Of--' Rece,pl No ~ C6 <f r-
Issued
Dala 7 I zj tf &; BY.4/ .t:7 '-"
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City Zomn Ordlna~ce and may proceed as.4tauested. ThiS document when
signed by the CIty Planner constitutes a temporary Certificate of Zomng compliance and allows construction to commence Before occupancy, a Certificate O(ckcupancy must be ISSUed.
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850