HomeMy WebLinkAboutBuilding Permit 99-0990
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SC_liEDULI:D
/O-Z2-'J'7 A. "(-i
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ADDRESS
5Z6t;.
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CON;R. - J
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
1SId'INAL
/0 SITE INSPECTION
COMMENTS:
PERMIT NO.
99-1fi()
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GA~E AI TST
o MECH FINAL ,X
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-
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)' WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspeclor:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl
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D,ATI= ~1=r.I=J\lF=Q
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CITY OF PRIOR LAKE tt'f()~.
. .
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I ~:G-q 1
1. White
2. Pink
3. Yellow
File
City
ApplicllIIt
C/9- 99IJ
Permit No.
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FtLLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
CD.rr/o..y~
2-
d;Q~5:'
(Address)
b'Lht (J:ifr,'",c.s...1Jdlr
(Address) "'
Chimney 0 Misc.
18. 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
building offici can r e 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.
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2. SITE ADDRESS
S ""2(,6
3. LEGAL DESCRIPTION
LOT
I
BLOCK
ADDITION
AI,
_~#t/PJ;;
14. OWNER (Name)
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5. ARCHITECT (Name)
c;:~^ C;
6. BUILDER (Name) ~ ..
AMu:""" tJII\o !a,'^3
C(intrQ c/<<5
7. TYPE OF WORK Fireplace LJ
New Construction CI Alterations [j
Septic LJ
Addition LJ
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width)
Ad/(
/Zls..o
(Depth)
12. NO. OF STORIES
PID zs-2S9- /)07-0
.C)7J,t-
13. TYPE OF CON}\TRUCTlON
/"'(Jff/~'
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
(Address) '-f
1"'/..1..'" Nt'clJ/1.l.. Av( f
OW1\.>V//lc.-
(Tel No.)
707-{; S's'"'1
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
DeckLJ
Finish Attic a
SEATS
Re-roofin~ Porch a
Re-siding CJ Finish Basement CI
16.jlROJECT COSTNALUE
q /,IJ(}tJ-
17. COMPtETION DATE
x
Signature
MATERIAL FILED WITH APPLICA TlON
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
eE:S. ~.K..-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. or
State Surcharge ............................. II:
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & WaterPennit ...................... $
license No.
Date
FOR ADMINISTRATIVE USE
Side Side SOIL TESTS " ENERGY DATA "
Back
. PILING LOGS " PERCOLATION TESTS "
OFF STREET PARKING
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY " COPIES
PERMIT V ALUA TION 7- aflJ . (/f) PLOT PLAN "
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7 <{. 7 ~
I- t. r-
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
e ermit.. .................... or
Beca e1)i{Uilding ;:,';it W~"Itit4'
I
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $~
7& -c/U
Total Due .............................. $ _
Paid Eif . cIJI Receipt fjp. ~ r r W
Issued /'" 't1~ /fA",,'
Dele 'i1~ By -_.~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning'Ordinance and may proceed aO'requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a CertificatJlf Occupancy must be issued.
This
By
CilyPlannef
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850
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