HomeMy WebLinkAboutBuilding Permit 99-0928
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
,"b -~2-'n
A .f";
ADDRESS
J?' 3Lf /J1.-. A ~ J'I_
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Q9.!J0J-?
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
iJ -SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~ ~
rI
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
~~
I
~
~~
.~
.---
( (ij~
--
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT wag, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . Owner/Contr:
v I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
OATF RI=C"::FHfI=n
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~l~O'iJ
7/30);1
1. White
2. Pink:
3. Yellow
File
City
Applicant
Permit No.
qq - 929
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 )<6") '1
1. DATE
7- -S(},~ ~
RIOCK
/l'1 w sk
I
v/Gw />1'
(Address)
)~)L.{ l'\o{~l ~t
~.
KI..s.o
BUILDING INFORMATION
11. SIZE OF STRUCTU~~
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
/
/5:L-~.A/ L)
12. NO. OF STORIeS
LOT
PID -Z5-/~J -0 OI-iJ
4. OWN ERr (Name) L
( "P((JTCJQ W"" c,r
5. ARCHITECT ""(Name)
(Address)
(Tel. No.)
1{L{7 - S'{,nh
(Tel No.)
13. TYPE OF C9'!STRUCTION
( p/<<>l-
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
Arre'<c",,,
(Name)
t7lA\I~"J Co,J.rO,dcf5
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace LJ
Alterations 0
(Address) I
/1-""l..f.n N;COIl.l.f...Av.. ),
(]....r"H';lle
Septic LJ Deck LJ
Addition a Finish Attic LJ
(Tel. No.)
7(n-6'r>1
15. NUMBER OF OCCUPANTS OR SEATS
Re-roofing)p Porch 0
Re-siding a ~inish Basement 0
SEATS
Chimney!j Misc.
8. PROPERTY AREA OR ACRES
Sq.FI. I ~
16. P'fjCT COSWALUE
17. COM~g.OODATE
/9. PROPERTY DIMENSIONS 110. CULVERT SIZE
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. 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 slate and local laws and will proceed in accordance with submitted plans. I am aware that the
building qtfpat ca~ r"oke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perlorm needed inspections.
X r.~- I/r 1...rJ{(;e.'')<iO ?--U>-Gq
I - .. Signature
License No.
Date' ,
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
B,ok
Side
Side
SOIL TESTS
!j ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
~s A/.A!!-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS !j
SURVEY a
SETS
COPIES
Z~.(/"'I...
PLOT PLAN
o
TYPE OF CONSTRUCTtON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... :t
Plan Check Fee ............................. $
State Surcharge ............................. :t
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... <<-
Collective Street Fee ....................... $
Sewer Tap ................................... ":'
7t./. ?s"
I. z.- r
$
Penalty ....................................... $
Pressure Reducer .......................... <<-
Meter Horn ................ .... ............... ~
Water Meter ................................. $
Sewer & Water Connection Fee ........... It'
Water Tower Fee ........................... $
Water Tap ................................... <<-
Builder's Deposit ............................ -~
other ......................................... <<-
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... <<-
Sewer & Water Permit ...................... $
:: :rl'7J1'l:/1i~~~i~~.~.e~it When~JlPro4J. y
By _'fttBtJ:.J /PJll7' Date .,fjd7't
I ( / I I
Certificate of Occupancy
Total Due .............................. 7t.. 0 0
Paid 7~. () C Recelpl)Jo. ;3c;-e I e
Date 7'3o/9~ By IHA....
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin Ordin{nce and may proceed is. 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.
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850