HomeMy WebLinkAboutBuilding Permit 99-0991
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
94/99 /l."T.
ADDRESS
/57/7 /"/r7Z!HEC- L--- (!Jk!. .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99- 99/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION A
,g,JINAL
ld'SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
AD GAS LINE AIR TST
~ "',,,,, F,'N.-tt--
COMMENTS:
.~ b\ ~ _______
\ // - ~
C1.C4 f)~ })
. ---Y
~-'.~
/
/
/
~ORKkATIS ~y. PROCEED
o CORR~T ON J NO PROCEED
o CORREC~ C / ILL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL, 47-9BI D FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ik,QUIJEMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
V INSNOTl
-~_.__.__._"--_._--_._----_.~_.__.__......_.--_..._._~.._.."---.--.,
.QAIE..PFr.FI\lFn
B/II /'11
. CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
)-'-((- qq
51? ,eIS.D
2. SITE ADDRESS I ~ 7/ 7
fIIIivc I.. e-ll
cf2..-
3. LEGAL DESCRIPTI9N
LOT I q-
~
PtJ/VO
PID ~6 - /S.s- - ()t{o -()
BLOCK
/11/ 7'l'~ Elf-
ADDITION
4. OWNER /1 (Name)
WI rUM A<)<; /v+tej
5. ARCHITECT (Name)
(Address)
5v-H-tB
(Address)
(Tel. No.)
<f-1-0-?7::13
(Tel. No.)
rf""'f"11 "'''''0'' .....
9~.~f.4V\1 ;>li:!:';d SI'nOl'.i~AddreSS)
OA 18 80lS130X3 00 ~ V
,ONI '9NIl3QO_V\I;'\H 'II mll"OOIil ~-S
7. TYPE OF WORK Fireplace CI Septlc'- Deck CI
New Construction 0 Alterations 0 Addition 0 Finish AWc 0
6. BUILDER
(Tel. No.)
Y..23 -~ D '&'
Re-roofin~ Porch CI
Re,siding CI Finish Basement 0
Chimney 0 Misc.
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-91/
BUILDING INFORMA nON
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEAT"
16. PROJECT COSTNALUE
7.?-.:> ->
17. COMPLETION DATE
B. PROPER'TY AREA OR ACRES 19. PROPER'TY DIMENSIONS /'0' CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building Off~'Ci I can ~voke this)t8nnit for jU?t caus . Furthennore. I hereby agree that the city official or a deSigns. e may enter upon the property to perform needjd it)fRections.
X ~ ~ /fJ..s-O 9'-( -1'tJ
d Signature lJcense No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......................._If'
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ......................................... $
Total Due .............................. $ -:7~. (/V
Pa;d 7(... 0 C) Rece;pt ~'" ?Ses-1'
Da!e 8/1,/';-'1 -;. ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Qrdlnance and may proceed ;/. 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.
SETBACKS: Required
Actual
Front
Baok
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
-Z nJ() _ tfl.J
USE OF BUILDING -----..e F: ~ ..v L-
'TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Permit Fee ................................... $
7..f..7r
Plan Check Fee ............................. $
State Surcharge ............................. $
1.2.5
Penahy ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & WaterPennit ...................... $
Thi
By
uUd;ng Perm;! W"t; (j'~V1'
Date 4 If
Issued
City Planner
Date
Special Condilions W any
24 hour notice for all inspections 447-9850
_._~--~_.._"---.__..._._._-----~ -", _..~..._._--- ..,~.._--~
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY CI
SETS
COPIES
PLOT PLAN
o