HomeMy WebLinkAboutBuilding Permit 99-1006
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULED
DATE TIME
ADDRESS /55 .Y~
OWNER
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A,/;
PHONE NO.
CONTR. _
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PERMIT NO.
99 -/.1" ~
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-
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
Js: FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
~OMMENTS: '~crrr;I ,/ f I
C./(;{~
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
~
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~~.
-. .1
-
-
-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~, CALL FOR REINSPECTION BEFORE COVERING
Inspector. t::t;T- . . OWner/Contr
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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DATf Rl=C":l=IYEQ
e//3/-;9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- /OOb
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
I SS'Lf 0 Dr.. ~ AVL tv. /AJ.
1. DATE
<;t./t3/q q
JeIS..o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID
?S-93ct-()/I3-o
ADDITION
A 67BS RND ,q t)(./ /1/ DS
13. TYPE OF CONSTRUCTION
14. OVjJjl'. R
I.Pu.'v1
15. ARCHITECT
6. BUILDER
(Name) J
5rr~L ~
(Name)
(Address)
/$5'10
(Address)
(T.1. No.)
Dr... I:J.. ,:4.v~ ~,IN,
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction LJ
Fireplace LJ
Alterations LJ
Septic 0
Addition LJ
DeckLJ
Finish Attic 0
Re-roofin~ Porch LJ
Re-siding LJ Finish Basement LJ
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERlY AREA OR ACRES 19. PROPERlY 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 cOlTect. 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 . iat can..,revoke this permit for just calfe. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm nefded in,ections.
X ,R <:::....", ~ --S!/..< q q
Signature license No. Date ~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS LJ
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.eES.
~//L
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS [j
SURVEY 0
SETS
COPIES
Z~J_O-V
PLOT PLAN
o
lYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... <1'.
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
<t
Pressure Reducer .......................... $
Meter Horn .................... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Division 1 2 3 4
Permit Fee ................................... !t
7<f.7S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I . ~S;-
Plumbing Permit Fee .......................9:
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tap ................................... t
This Builder's Deposit ............................ $
By Other ......................................... c;:
Total Du. ............................... ,c,U 0
Issued Pa,d ? (; .0 <.) R.C.~Pt Ng _ 5 f3fo q
Oat. f!Jh3/ q <1 By -
ThIS IS to certify that the request 10 the above application and accompanymg documents IS In accordance with the City ZOning Ordinance 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.
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850