HomeMy WebLinkAboutBuilding Permit 99-0877
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 10 -/~-'t'l A,(,
ADDRESS /L//9J FI J ~r;:)e./ AJ~(
OWNER CONTR.
PHONE NO. PERMIT NO. qq - ~ 7 '/
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ GA~IRTST
L. -,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)ll. FINAL
o SITE INSPECTION
COMMENTS: Pmr-1
I
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, (I I Fy.L(J
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
..
......................
:;'l.~" . ')
"..,-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
- I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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CITY OF PRIOR LAKE $'3b9/
BUILDING PERMIT, ~
TEMPORARY CERTIFICATE OF~
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
1. White
2. Pink
3. Yellow
File
City
Applicant
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
99 - 877_
1. DATE
7-1'1--0,1
1'1/ ClI
3. LEGAL DESCRIPTION
~
f'5L/
,4(Alt-
BUILDING INFORMATION
11. SIZE OF STRuCTURE
(Height) (Width) (Depth)
LOT
BLOCK
/I/O 1'L77-t' ..c:~,e ~
/
PID 2.~ -(}~e/ - 60t! - /
12. NO. OF STORIES
4. OWNEpll',' /
5. ARCHITECT
(Name) 1/
JI1,'c~vl 5
(Name)
471-1
(Address) .
1 1f111 F,'<;W' Ai/e;1!c
(Address)
;/';';-041&)
(Tel. No.)
13. TYPE OF CONSWUCTION
re /'p#
~OOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Name)
(Tel. No.)
707-1:9)''1
15. NUMBER OF OCCUPANTS OR SEATS
(Address) 1
1'1- '2-1/
J1 . /,? f,' J, (, 1 1 //,,'<:.1>/&1 k ,.
/j/V1-erILM ~'tJ/~ r-.IJl'fAd"O(5
7. TYPE OF WORK Flrepiice 0 Septic CI
New Construction 0 Alterations 0 Addition 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. L 8' 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 all construction will conform to aU existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
building Offi~ja!;an revok~..tJs permit for just cause. Furthermore, I hereby agree that the cily official or a designee may enter upon the property to perform needed inspections.
X /.c~-~ 'LJ1._/A9;~ ----2::-/......-9-"_
Signature License No. Date t
OCCUPANT~
Deck 0
Finish Attic 0
Re-roofinQ)!'(. Porch 0
Re-siding 0 Finish Basement D
SEAT~
16. PROJECT COSTNALUE
b;I?Of1-
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Baok
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
. BUILDING DEPARTMENT VALUATION
USE OF BUILDING
IZES A-/ /e-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PLANS & SPECS 0
SURVEY D
SETS
COPIES
PERMIT VALUATION
"2- m.-er-
PLOT PLAN
a
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... ~
$
Permit Fee ...................... ............. $
Plan Check Fee ............................. $
7t./. 7r
State Surcharge ............................. $
Penalty ....................................... $
;.2-\
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7(,. ell)
Paid ~ ~ .oz) Receipt No. 35(" {, "Z-
Date 7/trh"1 By ~
, t . _
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr~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.
GaSfll{);lrepl e e Itf."~'''' ........... $
Th~ n es IIdln9 Permll Wh7;~1r*1
By Date 1. S
I I ; /
Certilicale of Occupancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850