HomeMy WebLinkAboutBuilding Permit 99-1004
IJ. -&-11
6lft7 ~ Sr. .1/1
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
--3-INSULATION.......I rf1il
""" FINAL 11.> - M:r< I '01
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
VA'
/ ~.,-QP
LJ'P
v
DATE TIME
'19- /00'-1
o EX/GRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REIN5PECTION BEFORE COVERING
Inspector:
/fLfA
. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
_____..,,_..____._.__.__.,,_____.._____~__."._..____ _.____n_...___
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';ITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
r 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
{,1M RtJu,f/" ST JJE
oS ~/J.OD
1. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
Permit No. !l!J - / 0 of-
i fqj qq
BJSD
3. LEGAL DESCRIPTION
LOT
I
BLOCK
PID 7&:; -/9..1 - oa (- 0
I
WATE~ eD~ E:'
-'---
(Address) (Tel. No.)
{,Kbl Bowl;>, sr. {liE' PWl.UL
(Address) (Tel. No.)
ADDITION
4. OWNER
1)< 1.I(I&!-
5. ARCHITECT
(Name)
i~{)A skm.:t. oi.<..
(Name)
6. l\UI~~r:J_
('tN\ l!.4tunl
(Name)
(Address)
(Tel. No.)
Ba.nMIL Roof,;"j
7. TYPE OF WORK
bool L<.j,dc.h. ,4-J. S. ftfP~t!:oCtlq_ ~/Z) 7'1i-1{11D
Deck 0 . Re-roofing)f Porch 0
Finish Attic 0 Re-siding 0 Finish Basement 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
New Construction D
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES
Sq. Ft I/q.O
19. PROPERTY DIMENSIONS
Width Depth
/10. CULVERT SIZE
Yes No
BUILDING INFORMATION
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
SEATS
16. PROJECT COSTNALUE
II/DOO
17. COMPLETION DATE
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 aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offjfial can.revoke~ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X \/1 VlllUd.L \i(lljJ,U.u--t- . 2110"-1:4</ ,^/4/4Q
Signature Q License No. , Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ................. .... ...... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ... .... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2<)00, -
USE OF BUILDING
//c, r:J/.e..
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .............. ..................... $
City:
S U
7~'7S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.................. ..................... $
Plumbing Permit Fee ....................... $
/ . z.s-
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLA nON TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
: Gya'S:~B itnm..~...70.~I.......~.a.et';:'$,.tWI'leeV. fA!;.~'rol.'!l\!d~ Water Tap ................................... $
~ rOl lY I..J'/C, Builder's Deposit ............................ $
Other ..... .... .... .... ........................ $
Certiticate of Occupancy Paid T7;~~'0""'''''''''''~~~i~;~O$ ~~ZZ
Issued _ ,_
. Date S/IJ;f''f 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 procee{J.s 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.
CilyPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447+9850