HomeMy WebLinkAboutBuilding Permit 99-1023
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
15RzZ.
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L~ D i ('()Jg Ie...
SCHEDULED
PHONE NO.
CONTR.
PERMIT NO. q't - 10 Z, '5
OWNER
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATIONr.J\ 0 SEWER HOOKUP
J!I FINAL (ff./ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
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f/~ La
"t;:.,...L.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ C3.:tc Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
._.._____._.'._.'m_._____,.___._.__.______~___._
~\
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
. ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~~'Y'
fJ2~,i
8/le/CfCJ
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
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3. LEGAL DESCRIPTION
(?-~
6-",
ICfSQ
LOT
PID,z5- Q30-(JZ...7-0
.
BOU /1/ oS;
BLOCK
/'-I6rES rlNO
ADDITION
4. OWNER
(Name)
(Address)
(Tel. No.)
5. ARCHITECT
(Name)
(Address)
(Tel. No,)
r-~~;) Ja17~/?J-ddreSS~/3~
~"~;i;~.JM1~;" Fireplace 0 Septic 0 Deck 0
, ew Construction 0 Alterations 0 Addition 0 Finish Anic 0
P/r"..p,. (~)o)
i,t/721cYU
Re-roofing ,....., Porch 0
Re-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. c;q - /02....3
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Wtdlh) (Depth)
12, NO. OF STORIES
~E;?~TlON
14: FLOOR A;':: 8PORTlONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished' rmation on this application which is 10 the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the.a. b, ove m~~~perty an t alt construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
., Offici~_TYJe ..~just cause. Furthermore, I hereby agree that th~;;fficiat::j,:"gnee may enter upon the property to ~~...
~ Signature License No. Date
17, COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. ,It:
Park Support Fee ........................... .or
SAC """""""",,,........,,,,,,,,,,,,,, $
Collective Street Fee ....................... ~
Sewer Tap ................................... ~
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z. '>L5V. c/V
USE OF BUILDING
.leF.: S ;1'1/ L-
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
ON";," 1 234 '7L/.75
Permit Fee .................. ......... .... .... $
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
/.z-r
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS LJ
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
$
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ......... .... ........ $
Pressure Reducer .......................... $
Meter Horn ....... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $~ .00
Paid '1 to ' 0 0 Receip~!}J _ '3 58 <7 ()
Date ~//0/q1 By A'Ja _
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 'Ordin/nce and may proceed,r 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.
Sewer & Water Permit ...................... $
q
Issued
CilyPfanner
Date
SpecialConditions~any
24 hour notice for all inspections 447-9850
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