HomeMy WebLinkAboutBuilding Permit 99-0904
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~-t8.qq 10: 00
ADDRESS Wi4c., -f?gr~ g.. ~
OWNER
CONTR.
PHONE NO.
PERMll'NO.
'1'l-'1d-1-
o FOOTING
o FOUNDATION
o FRAMING
DILATION
INAL
SITE INSPECTION
@J
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ~+ +l'V\a \
~~ ;t~ ~. 4~
~~-; -.. "5)
~ ~ ..'
( ('~ "4,&.. 1
'- --~
~' ..,.L-->
J
..--
/
LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WI2K~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: l!:?f r ( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
" .._.....----.__n_. _.___.____n.____..____._......___...__..___.._..._
~1
";7;E;791
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.
9'1 -qot/
,
I DIRECTIONS
~CES NUMBEREO 1 THRU 17 MUST BE FILLED IN
'=l.E PERMIT IS ISSUED (Please Print or Type and sign at bottom)
E ADDRESS
l'-l9l./C 'fl~X;-e p+. 0.....1.. SE
1. DATE
,-;21- c:rq
Ie/ S D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
{Height} (Width) (Depth)
3. LEGAL DESCRIPTION
LOT Jt/ /"- 0 ~.3
~..5'7W 000
14. OWNER ErJ..
12. NO. OF STORIES
. BLOCK
PID ?P5 -047- tYJt,-O
13. TYPE OF CONSTRUCTION
ADDITION
IYT
5. ARCHITECT
(Name) J
F el KeV'
(Name)
(AddreS~ . (Tel. No.)
I '1 q Ltc;. l-'iYit" 'P+- 0 rr Ie5C
(Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT"
Go-a.1JSJ..n-t.e.\,~ RvtJ\5 n3/7C+ tZJ 1/
G{?- '6il';).68gS-
SEATS
16. PROJECT COST N ALUE
7. TYPE OF WORK
New Construction ~
Fireplace LI
Alterations LJ
Septic 0
Addition 0
Deck Q
Finish Attic 0
Re-roofing.tJ Porch CI
Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
1 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 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 that the
buildi~ ojficlal can reVOke{V1. r's If""'t for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to peIform noeded lnepec:tions.
X K (1) n~_ vI~.Q{",," j::D:#>- ;2n1"{3r,<t7
- Signature J License No.
17. COMPLETION DATE
r:-
Dale
FOR ADMINISTRATIVE USE
Front
B.ok
Side
Side
MATERIAL FILED WITH APPLICA nON
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS Cl SETS
SURVEY Cl COPIES
PLOT PLAN Cl
ACKS: Required
Actual
USE OF BUILDING
L':GS AIL
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V ALUA TION
2~. n.../
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION' I 11 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ............................... .... $
S U
7.,1. 7<;
City:
Amount Brought FOlWard .................. $
Park Support Fee ........ ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... <t
$
Plan Check Fee ................. ............ $
/. z...r
State Surcharge ............................. 4:
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ...........................:t
Penalty ....................................... !t:
Plumbing PennitFee .......................!t
Mechanical Pennit Fee ..................... $
~,:liJi+~~;i~~.i:,~1l7e*~o/~1
/-r-- I I
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $-2fO' 0 0
Pa;d f". 0 0 Receipt Np. . ~ S'h ".,t
Issued .
Date lZ.7/t:jQ By
is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni Ordina'e J may proceed requested. This document when
...<\lned 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
Date
Special Conditions ~ any
24 hour notice tor all inspections 447-9850