HomeMy WebLinkAboutBuilding Permit 99-0872
DATE TIME
CITY OF PRIOR LAKE 7-2/- qq q:Zv
INSPECTION NOTICE SCHEDULED
-
ADDRESS 14330 ~. ~
OWNER CONTR.
PHONE NO. PERMIT NO. 9q - nZ-
o FOOTING
o FOUNDATION
o FRAMING @
~NSULATION
FINAL
o SITE INSPECTION r
COMMENTS: ~~ t
~'~~(O~
y1~ .".:.,.J'~.;;;
-- ~ ----
C ('l!ooe ~)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
D*~L
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
L 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!
INSNOTJ
16. PROJECT COSTNALUE
, ...;, ~ a.>. (){)
I :i::OPERTYDI~:p~:'ONS I :~5CULVERTN~IZE 17. co '.f 79Jt~ '
R
. formation 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 m~e perty , d at all construction will conform to all existing state and locallaw$ and will P, roceed in accordance with submitted plans. I am aware that the
bUilding 0 I ke it for ilj>t cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfor;n ~~ons.
X _ ~ ~--' ~~~f
./ ' Signature license No. ,r DateP
DATE RECEIVED
-7?7'/f7-
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
f~~/t;9
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDRESS
/ij::<.''fO <: ~''''''''/A..r A/ /.
3. LEGAL Dj5CRIPTION
lOT ""I ~LOCK
ADDITION ,")CiVld Fb>l1le
~
4ft' /lddJ1
PID :!)'-;;L[i)-() 7Lf-()
~NER (Name)
d~r~zA~ /~<~O ~:..lwd",
5. ARCHITECT (Name)
(Address)
I.wl{ ME' S"s-Y?i1-
(Address)
(Tel. No.)
'l"q~-/tJOtf
(Tel. No.)
(Name)
(Address)
(Tel. No.)
6. BUISel!
~?'-:'.).'1 it". (p. I("'
7. TYPE OF WORK Fireplace [j
New Construction 0 Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq,Ft.
SepticLJ
Addition LI
Deck 0
Finish Attic CJ
Re-roofing rJ" Porch 0
Re-slding 0 Finish Basement []
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 99 - B 72---
BUILDING INFORMATION
", SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO,,"STORIES
13.hPE OF CONSTRUCTION
/('qq-f/N~
14, FLOOR AR(I( APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS, .s"
SEATS
v
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION Z~.~
USE OF BUILDING
PFS AjlZ..
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penally....................................... !to
Amount Brought Forward .................. It;
Park Support Fee .... .... ................... <t
SAC ......................................... $
Collective Street Fee ....................... It;
Sewer Tap ................................... or.
.
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ~
Water Tower Fee ........................... .t.
Water Tap ................................... It;
Builder's Deposit ............................!t,
Other ......................................... It
Total Due .............................. $ 7b. au
Paid IG. 00 RecelplNo. .56(.,5'7
Dale 7/;<//tiq By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zonin6 Ordinance and may procee~s 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.
City,
/'</.7S-
/,z..~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace P rmit ... ................... $
This Be ding Permit whenA.ppro""d:z
By Dale 7//'174_
I I
Certificate of Occupancy
Issued
24 hour notice for all inspections 447.9850
Special Conditions ff any
CRy Planner
Date