HomeMy WebLinkAboutBuilding Permit 99-1012
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCIi~DULED
iJ..3- 9'\
ADDRESS
50:)/ /..../J
1\ '" D uz.g~ S1: 5_15.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
11. - /01:1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION .fA)
;SC FINAL MnrlI.[J/
o SITE INSPE-C1RlN
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
()fr
~b
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/lL-t?A
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
&~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
AUG 'I I9ll9
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12SITEADDRT-~M C t\tl55CiLVj/~/t
3 LEGAL DESCRVION
LOT " BLOCK I
ADDITION t. 5"- Z. 7"1 - 008 - 0
14. OWNER l-p(Name) II ^ (Address)
< Te. ~ - M I err<>. j',,-tv...€.-
15 ARCHITECT SELA(r,jjffi~""AI ' . (Address)
ROO... .!.,@ & /ilfiMOD!"UNr.l II,'^
6. BUILDER M,.1tl!; "^\'!ebS/OR BL VOOddress) -.
'I(jbJl_~ F'A/ilK, MN 55416
101/tlOt}10S0
1. DATE
5t.
?-/(-qq
sf:-
PID
"7 c-2.."/9 .-003-0
(Tel. No.)
++0 -8 q7{"
(Tel. No.)
(Tel. No.)
rr;;")~Or-o
1, White
2. Pink
3. Yellow
File
City
Applicanl
Permit No. qq -10/.;)--"
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
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofin~ Porch 0
New Construction 0 Altera]lPps 0 Additiof.? Finish Attic 0 Re-sidlng 0 Finish Basement 0
ChimneyO Misc. ;-e~\.ol-'- A...tQ.1l0 - It()(/.<,~ ~~
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Fl. 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
:UiJding o~ permit for ju ause. Furthermore, I hereby agree that the city official or a designee may enter uiO~6operty to perf/orm :ert-ii/'fions.
V S ore U""",, No e1-p. ';-~/-;;bJ1) 0".
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
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 ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other .......................... .... ........... ~
Total Due .............................. $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~,"Oo :..0
USE OF BUILDING
IZe5 A- /1<-
,.
TYPE OF CONSTllUCTlDN: I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
1'1, 75
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/,25
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This ~~o~comes Your Building Permit When Approved.
By , ~ Date r-/~ -99
Certificate of Occupancy
Issued
Paid
Date
16. PROJECT COSTNALUE
<:1,000
17. COMPlE~ r.;:, "I q
$
7(/7 _ -
Receipt No.
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 as requested. This document when
signed by the City Planner constitutes a temporalY Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
By
City Planner
Dat.
24 hour notice for all inspections 447-9850
Special Conditions ~ any
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