HomeMy WebLinkAboutBuilding Permit 99-0861
DATE TIME
SCHEDULED /0 -/'1 -,,/, A.-"-;-
PA?::._~ ~./.,
L./
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/5,<)/()
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:~~ ~
(fIlA<<- ~
~,,~
'9'7~ &. I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
; GA~TST
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: f:;f.:r- , Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNS/'iOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
QATF RFC':FI\lED.
//12/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-r0/
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADORES' S '3 } 0
r~
(
[ vev0
1';7/1.!QQ
.e1.>P
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
.~
/'1 #R77 IV.J 0 tV S
14. OWN~ (Name)
\ G" \ \t/'Co '^" .er
5. ARCHITECT
12. NO. OF STORIES
LOT
BLOCK
PID zr;--o7/- 004-0
ADDITION
/Sc-
13. TYPE OF CONSTRUCTION
(Name)
(Address)
1<;1111 ~ urAu
(Add res
(Tel. No.)
Y41\-(".8IR
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction LJ
Fireplace LJ
Alterations LJ
SepticLJ
Addition LJ
DeckLJ
Finish Attic LJ
Re-rOOfing~ Porch LJ
Re-siding LJ Finish Basement LJ
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
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 I am the owner or authorized agent for
the above men~'onoo rty 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 official revo is p'e~or j~sy:;ause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neOO1d insp~ions.
X _rA_Dy~ \<v-;-_^'-_ ~. . -, !-O..J '1')
Signature License No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Baok
Side
Side
SOIL TESTS
o ENERGY DATA
o
~ fl71L-
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
c.~~
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
Division 1 234 7 <<-t. 7r
Permit Fee ................................... <I:
Ci1yo
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. ~
1.'"2..\
Penalty ....................................... $
Plumbing Pennit Fee ....................... !t
This
By
Pressure Reducer .......................... $
Meter Horn '" .... .... ................. ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... ~
Sewer & Water Permit ...................... <t
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7 h. dO
Paid /@.a () ReceiptJiq. :::iGlPcJb
Date 7 kJfl By ~
This is to certify that the request in the above a~lication and accompanying documents is in accordance with the City zonini Ordi"'~/nd 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 ocrancy, a Certificate of Occupancy must be issued.
nnit ..... ................. <t
log permnJ:fJ:lrl fiip.lP9,C;
Date ~r7
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850