HomeMy WebLinkAboutBuilding Permit 99-0921
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL~D
DATE TIME
(~-I'f-?i A.T;
ADDRESS
-?t't1?5'5 ~.~,
OWNER
PHONE NO.
CONTR.
PERMIT NO. C?'f-C( 2-- /
o FOOTING
o FOUNDATION
o FRAMING &J
o INSULATION
M' FINAL
b SITE INSPECTION
COMMENTS: ~
4~
/ ....
,~. :~
I (~~/k )
\. --
........ -----
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
(~
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
./
LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR? :ALL FOR REINSPECTION BEFORE COVERING
Inspector: 1Y1 J... ( Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSiVOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
---~_..~----~.,.,.",..-
;J~;7;9.
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.
9t?- 92- /
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at banom)
2. SITE ADDRESS
L/ q?,S M mV\, <"+-
1~7301 <ry1
/!!.z---.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
/2..
BLOCK
/2-
PID 25 -66/-()9t:>-O
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
"10\'\\1
5. ARCHITEC1
(Name)
( ov\ ('oV
(Name) 1
(Address)
'i1'1/) /\1lntL Sf:
(Address)
(Tel. No.)
l./t-{i- ~J 1 'i
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name)
~r-wser
(Address) J ()rd Or)
~rofI 3&'5D w ).OO~
Fireplece 0 ~ Septic 0
Alterations a Addition LI
(Tel. No.)
~q ), :31'1 J..
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Chimney (] Misc.
a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width. Depth Yes No
I 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 local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding official revoke is permit for just cause. Furthermore. I hereby agree that the city offd'lJi js~n7 ;v ~er upon the property to perfo-7 h~ mons.
Signalure License No. Date /
Deck 0
Finish Attic 0
Re-roofing,p\ Porch 0
Re-sidlng 0 Finish Basement (J
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Frnn'
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS a PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
Re S /1/fi?-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS i""J
SURVEY i""J
SETS
COPIES
2 57:S7:J. C/U
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division t 2 3 4
Permit Fee ................................... $
S U
7..t. 7'")
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .......... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
MeterHom................................... $
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
PlulTtllng Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/. Z.S
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7(" .00 Receipt
Date 7/ zt:;/qq
This is to certify that the request In the above application and accompanying documents is in accordance with the City Zoning Ordinab and may pr 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.
7f,.QO
358/0
Gas Fireplace Permit .. .................... $
This lIdlng Permit Whei ApprcJ~
By Date '7/ v:r / '1-/
, I
Issued
City Planner
0.10
Special Conditions if any
24 hour notice for all inspections 447.4230