HomeMy WebLinkAboutBuilding Permit 99-0870
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.- ,
~
SUtJFlS H ~.
AT.
ADDRESS
/01)06
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq ~ 970
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~ 0 GASLlNE AIR TST
o MECH FINAL CC!5/ X _RLmF ,q,,-ytL.-
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COMMENTS:
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~
( ~ t:fJJl '; )
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LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ i ' Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
~~
DATE RECEIVED
'7/13/99.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.V< wrote
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99 - 970
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2JS TE ADDRESS r I j s:
L- ~ ":> uA/ I'; .-I"'/'. .. E
3. LEGAL DESCRIPTION
1. DATE
7-/3-79
? L:
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
PID Z5-CJ02-///3-0
13. TYPE OF CONSTRUCTION
ADDITION /'16755 /,'1/
4. 9ft!~; /'<t /~, b qk
00 UN' as
5. ARCHITECT
(Name)
(Address)
Itp~o 5vr'lrd 1/:
(Address) .
(Tel. No.)
Lf'fo- ZZ~D
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
;; r? .:~
~
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofingIt' Porch 0
Re-siding 0 I ltinish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for
the ab . ed 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
"...... I dit)9 official c reveke this . it fo 7t ca se. ~~erebY agree that the city official or a designee may enter upon the property to periorm needed inspections.
X I k_ 7-/~-~if
/ Stgnature /"' License No. Dale
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICA TlON
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
k?ES /IlL
I
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS D
SURVEY 0
SETS
COPI.ES
2- .r7J\) _ c7L--
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
s U
City:
Amount Brought FOlW8rd .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... 'l:
$
Permit Fee .................. ......... .... .... $
7 </. 1)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/. -z."--
Pressure Reducer ..........................4'.
~~'S 0 :I.t ../iii~.i:~lt77rrl'l7
Certificate of Occupant
-IrQ '00
Paid 7 6 . c! 0 Receipt No. :3 5 rc 5 Lj-
Issued
. Date 71r3/q1 By .A1A--
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoning'Ordinance and may procee~qUested. 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.
Meter Hom .,................................. $
Water Meter ................................, $
Sewer & Water Connection Fee ........... $
WaterTowerFee .........,.............,... $
Water Tap ........,.............,............ $
Builder's Deposit ............................ $
Other ......................................... 'l:
Mechanical Permit Fee .................. ... $
Sewer & Water Permit ...................... $
Total Due .............................. fl:
GityPlanner
Date
Special Conditions W any
24 hour notice for all inspections 447-9850