HomeMy WebLinkAboutBuilding Permit 99-0998
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEb
DATE TIME
I }. - ']Ai' '\
ADDRESS
s'</{{ ~ SJ S.c.
CONTR,
OWNER
PHONE NO.
PERMIT NO,
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING Ii0 0 WATER HOOKUP
o INSULATION~ ~ _ 0 SEWER HOOKUP
~INAL M "~D PLUMBING FINAL
o SITE INSPECTIO 0 MECH FINAL
0/1
COMMENTS:
/ff...,.,o L'i/"
v I
'? 9- 7 If If
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspeelor:
~
. Owner/Conlr:
CALL 447-9350 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
o IJ"
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ei!?Lr<{j
o RE E CITY OF PRIOR LAKE
-h4 9~7 BUILDING PERMIT,
...II) ;;J. TEMPORARY CERTIFICATE OF
#'7~, "" ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq - 99PJ
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SISTE A~~~:Sl
7~\? 130uflfv sf. s~
1. DATE
11- 'Cf- qg
Ie/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3, LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
-.3
PID z5-/P.7- ('J4?-{)
C,m
13. TYPE OF CONSTRUCTION
/.3
f?PO(,,)JCSVII~IP:
14. OWNER . (Name)
SUrr--- V,k.t;' #e/sDYl - 5</"1.-
15, ARCHITECT
6. BUilDER
ADDITION
HI(I.5
(Name)
(Address)
Boun Iv sf-
(Address)
/J (Tel. No.)
S;E; rf'/~r L.f...
(Tel. No,)
4<10"
/f?/.'3
14. FLOOR AREA APPORTIONMENT USE
(Address) (Tel. No.)
g//,? 5,.,,,,.Mr~,J A-ve~.
mpls mN .>5"'10 V,
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Rs-roofing'" Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding)( Finish Basement 0 16. PROJECT COSTNALUE
z-G ~c"
Chimney r:l Mise, /:z J "/ d).....
8, PROPERTY AREA OR ACRES '[9. PROPERTY DIMENSIONS 1'0. CULVERT SIZE 17, COMPLETION DATE '?
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 official can revoke this permit for lYst cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
.-x~ C/_...r ~/7q //-I'9-'9&'
/ Signature
(Name)
/k".zICrQ/',t ".?' /1'1~
15. NUMBER OF OCCUPANTS OR SEATS
7~'-
~f/;;J.K
OCCUPANTS
SEATS
license No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS r:l PERCOLATION TESTS r:l
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2'6 S r1jK-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
COPIES
SURVEY 0
2/~ DO, {fO
PLOT PLAN
r:l
TYPE OF CONSTRUCTION: I 11 III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
s U
City:
Amount Brought Forward .................. ct
Park Support Fee ........................... ct
SAC ........................................,$
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee .............. ..................... $
7475
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
/,2-5"
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ........................................, $
Sewer & Water Permit ...................... $
:f3.:.Flr~11:~~~...t;iftt..J.;~......~....~.~.e:" Whe~~prov96...a
By ~ i~ Date P. /2./'9'-1
/ / .
~ertificate of Occupancy
Total Due .............................. ~ "7/:;,00
Paid 7(. ,00 ReeeiptNo., ~C;f3(" Z-.
Issued~_ "
This is to certify that the request in the above application and accompanying documents is in accordance with the c~:;oj~~:-i ~fy pr::.,ested~ThiS document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certiftcate of Occupancy must be issued.
City Planner
Date
Special Conditions it any
24 hour notice for all inspections 447-9850