HomeMy WebLinkAboutBuilding Permit 99-0946
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEpULED'
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L-N.
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ADDRESS
/4- Z 2- ~ .5 I-!tJeE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q 9-9'-10
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXIGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUWD FIREPLACE FINAL
o PLUMBING FIN GASLlNE AIR TST
./ MECH FINAL ~~
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/ , '
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COMMENTS:
"'
LK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT VU;;K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: " Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
2.SITEADDRESS/'f..-,. "'L.)
~ 9,/lr<-- ~ ~
/11 i-.
1. DATE
<6-7...-"; ~7
PO .0
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
6. BUILDERA ,IName);J ;/1.
Nr.cfi\A. C'IA,(tIf'''!J
Ct/r\ -f,Pltlo,"i
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. "La- 7 Width Depth Yes No
I hereby certify that I have fumished 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
building off~al ~ revo.ke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~~J "1.-0//:,4,1<-<. 5i-'_'"L-t}4
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Signature license No
3. LEGAL DESCRIP~
LOT I
BLOCK
514#0 ,,:'7
4. OWN ERn (~ampl.
Uo.~:~ L h '" i>I k,;/,>
5. ARCHITECT (Name)
ADDITION
3
4-rlrI-"
PID ?'5'Z/S" ~ ()I./o-Q
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq~qt/h
(Address)
1..('2..7...5" <JAbIV
(Address)
(Tel. No.)
L/I 'f'IG-1 --In
(Tel. No.)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heigl1t) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CON~TRUCTION
/".er00f
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
~PROJECT COSTNALUE
// t;(!(}I}-
17. CfDMPLETION DATE
(Address) ~. A.
/"-'7- '1'1 ,;V,"alle./-- /TV" J.
fl"'IA>V//lt....
Septic 0 Deck 0
Addition 0 Finish Attic 0
(Tel. No.)
707-
''15'4
Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2ES .e:rl.e-
TYPE OF CONSTRUCllON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Amount Brought Forward .................. ct
Park Support Fee ........................... It
SAC ......................................... C:
Collective Street Fee ....................... It
Sewer Tap ................................... $
$
Re-roofingj( Porch 0
Re-siding 0 Finish Basement 0
FOR ADMINISTRATIVE USE
Bad<
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z: rlf?I _ G/V
S U
City:
#1~
/, 1.- r
MATERIAL FILED WITH APPLlCA TlON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
Ll
Pressure Reducer .......................... It
Meter Hom ....... ............................ <r.
Water Meter ................................. <t
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ It
Other ......................................... lI',
ilding ~:tr:it WJ7Ajp!J,r
Total Due .............................. $ 7(,.00
Rece;p'Ai3Sf1JZ- L-
Date 8/41 qq By 1;1f:!<.-- "
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonirf"g OrJnance 'nd may proceed r ~uested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a UCI u""",'c of Occupancy must be issued.
Issued
cny Planner
Paid
Date
24 hour notice for all inspections 447-9850
-zt. . (J 7)
Special Conditions if any