HomeMy WebLinkAboutBuilding Permit 99-0890
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULE'=- &~ -5'9- / ;,' :s <J
ADDRESS 4r?>?'5 ElL IJJ C.Jter!.L.E,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9~- 9JQO
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)( FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: fa", p.
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Lm,^'ro~._"w
o CORRECT ACTION AND PROCEED
o CORRECT WJf~' CALL FOR REINSPECTION BEFORE COVERING
Inspector: b"0 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSl'iOTl
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]lATF ~Fr:FIV~ 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. Cfl, 8~O
. DIRECnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1./'b'f>S Ej\~(\ Lll'c.\e. SE 9r\n~
1'7/1.1/99
RJ'S-P
) .,.1c.e.M~ t::j'737Z
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT
Ie:;
PfZ-\ofZ-.
BLOCK I
SOUTH
PID
t7 S-() 17 -()I S- 0
12. NO. OF STORIES
1.
ADDITION
14. OWNER (Namtl,.
'Va.", \ Vt> l' e?
5. ARCHITECT
(Name)
(Address)
~at\\P ~IN.
(Address)
(L#.t7~ b75"'-I
'3. TYPE,C{F CONiTRUqlON
54?\I'\- L e.lI!. \
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
So..~-c.
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing)ll- Porch 0
Rs-siding 0 Finish Basement 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
110. CULVERT SIZE
Yes No
17. CO~/.;qATE
t hereby certify that I have furnished information 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 mentioned property and that all construction will conform to all existing state and Jocallaws and will proceed in accordance with submitted plans. I am aware that the
building ~~at can rMk~iS permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X y _\'~_
Signatur{) Ucense No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Fron'
"ok
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
I OFF STREET PARKING
SPACES REQ.
USE OF BUIL~~
J!lJ fi:.-
I
TYPE OF CONSTRUCTION: I II III IV (jj)
Occupancy Group A B E F.~ I M rB) S U
Division 1 2 tJ' 4 S--
PelTT1itFee ................................... $ 7 '-/-,-7
SPACES ON PLAN
SURVEY
PLOT PLAN
Ll
Ll
COPIES
PERMIT VALUATION ~,'5"oc:>. C'JO
City:
Amount Brought Forward .................. or
Park Support Fee ........................... it.
SAC ......................................... or
Collective Street Fee ....................... <t
Sewer Tap ................................... or
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennlt Fee ....................... $
1.2~
Mechanical Pennit Fee ..................... $
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid ReceiPJ.,~' 'S'S'c,? tj
Date 7~?I-q1 By 6!h .
Sewer & Water Pennlt ...................... $
::~'rel;Jp:1~~..~~.... .......... :itW..II.enAlwrovljll.(
BY~'" Date -1- G.-I I
. ,;-
Certificate of Occupancy
Issued
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as 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 Planner
Oate
Special Conditions if any
24 hour notice for all inspections 447-9850