HomeMy WebLinkAboutBuilding Permit 99-0878
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ItJ-fP-79 A- .T:'
-
ADDRESS / <-/375 -:J.~~ A:;e.
OWNER CONTR.
PHONE NO. PERMIT NO. 99 - $'7 j?'
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: 4 ~
"~~
( (I~
-
o EX/GRAD/FILLING
o COMPLAIN'T
o FIREPLACE RI
o FIREPLACE FINAL
o G~~?IR TST
JC
~~
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S:~:~:CT WOh~L FOR REINS:::::::::FORE COVERING
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
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
A -3(;3')
I.
-,i
Permit No. '?9
- f37t-
I 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 IIi)7!) t;'5hv A.e. ;Vtf
W1Ute
PlDk
YelJow
File
City
Applicant
3. LEGAL DESCRIPTION
LOT 9)
I
ADDITION
BLOCK
Ai 0 /e...TH SdtJK..C
_pro
(g'11f
(Addre~
I Jf37S" Jr/.;w k /JIG
4 OWNER &h (S~Mr
5. ARCHITECT (Namey
(Address)
15. NUMBER ur UvlJO"'ANTS OR SEATS
6. BUILDER (Name)
Atkif,: 5/dtj , Coni-I,
7. TYPE OF WORK..) Fireplace 0 Septic 0 Deck 0 Re-roofin~ Porch CJ SEATS
New Construction 0 Alterations CI Addition 0 Finish Attic 0 Re-siding 0 Finish Basement D I' ~PAOJECT COSTNALUE
Chimney 0 Misc. ij' 6:s-oo _
B. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 1'0. CULVERT SIZE I 17. COMPLETION DATE
Sq. Ft. L"J Width Depth Yes No I
I hereby certify that I have furnished information on this application which is to the beSt of my knowledge true and correct. J also certify that I am the owner or authorized agent for
the above mentioned 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 thai the
bUildin~ 2fJieial can ,,~ this permit for just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed inspections.
X -.t::_- A5I ~/..,<:;>~, ?-/~'7<;
Signature licenseNo. Date ,-
(Address)
/'7.-'2.-'17
/Y/co/ &{.4ye >..
1. DATE
7-1'I-C; 4
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
K.ISLJ
z.~-z...,,"; - OO~-O
12. NO. OF STORIES
(Tel. No.)
~'1~ 5J/t{
(Tel. No.)
13. TYPE OF CONSWUCTION
r-rr nr.J!
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
7~7-b15~
OCCUPANTS
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
MATERIAL FILED WITH APPLICA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
Side
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION ? fO'2J.~
USE OF BUILDING
/CbS' -f/L
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
7~lr
City:
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ............. $
Plumbing Permit Fee ....................... $
I.z.-r
Mechanical Permit Fee ..................... $
Sewer & Water::~/.'................... $
~;~;~;,~I~~i;;lt~e~^r~/f
II '/ I I
Certificate of Oclupancy
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. <I:
Park SuPPOrt Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... ~
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meier Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ~fo_e7V
Paid '/ h . VU Receipt NQ. 1'"- ~ , Z-
Issued , . _
Date 1/1 r I Cj Cj By /JJ.A--
This is to certify that the request in the above application and accompanying documents ;s in accordance with the City Zonin6 Ordi"tnce and may proceed eJ requested. This document when
signed by the City Planner constitutes a tempora'Y Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850