HomeMy WebLinkAboutBuilding Permit 99-0910
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S81(n
DATE TIME
b -Z? -,?
A.7;
711~ g,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
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-
9Cj - 9/()
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GA~~R TST
~ __vI' .
./
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: I~r . Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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X PR/O ~~~~
C\,~~'I? <: !).ATF RFr.EI'lEll CITY OF PRIOR LAKE
~ ~ - BUILDING PERMIT,
u C1
~ TEMPORARY CERTIFICATE OF
1 J ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS l.t1Il t:: I
~SU Ie J' /0 rP-h Jt. J..{, '1).
I ;q7~0 /q'q
I
J:-1"sJ)
3. LEGAL DESCRIPTION
~
1St-
BLOCK
VIE:W
I PID .2!i>-/4.'?- ooZ-O
/rT
(Addressh/\ , . J /'I(Tel. No.)
:;<,g1J - "I f!J.c:h ~. ~ I ~)
(Address) (Tel. No.)
LOT
ADDITION
~ri
5. ARCHITECT
.D:rW{\ h \
(NaPme)
6. BUILDER (Name)
/t~, -:tnC,
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction LJ
1;J..qL)7 J,Jicdlef. ItW.SQ. f.!c/~.J70?~hq[;'
Fireplace LJ Septic LJ Deck d Re-ro~ Porch LJ
Alterations LJ Addition LJ Finish Attic LJ Re-siding LJ Finish Basement LJ
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 99 - <?/O
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(He~hl) (Wkllh) (Depth)
12. NO. OF STORIES
1~r:-;::;;:tSTRUCTlON
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
. t45rfDCJt~S5~E
17. COMPLETioN bATE
Chimney LJ Mis""
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. ~ 2> '2JJ Width Depth Yes No
I hereby certify that I havd 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~ve 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 a wa ra that the
buil'n 'cial can revoke t~is lTT1tt r 'ust cause Furthermore, I hereby agree thatAe 9..,ity official or a desi,9,.nee may enter upon the property to pertorm needed i~pections.
X J(\ ~ dUlloq ~S< "5 "'1-' ~ 1'fIf
Signature License No. I ea.
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn .................... .... ........... $
WaterMetar ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ? to . UU
Pa,d -zt. flU ReceIPt~(} swV
Issued Dalei7.-1 / ft:1 By ~~
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance With the City Zom 9 Ordl"-nce and may proceed a uested ThIS document when
slQned by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupancy, a Certificate Occupancy must be ISSUed.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
"2<r7m. uU
USE OF BUILDING
LES .-r/ e...
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City,
Division 1 2 3 4
Permit Fee ................................... $
7~7)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... of:
I. z..r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... <I:
Sewer & Water Permit ...................... <I:
C~yPlanner
Date
Special Conditions W any
24 hour notice for all inspections 447.9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS
LJ ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS LJ
SURVEY ()
SETS
COPIES
PLOT PLAN
o