HomeMy WebLinkAboutBuilding Permit 99-1028
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCH~.rULED
DATE TIME
/o-/P-99 A. r:
ADDRESS
'L/ ...1\. / /7 /l' /
/71..5:::- ~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATI~ 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
o SITE INSP ON 0 MECH FINAL
COMMENTS: ~ ~
((P~
q q-/().;J-3"
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
; GA~IR TST
-I~~
- , )--
rL&, )
---
-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ , Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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8//R;i9cr
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -It) 28
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
JL//~,-::t-... nvcl'L...J r./Jf.
1. DATE
.t::/SO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID ;;?5.930 - o<l9-Q
13. TYPE OF CONSTRUCTION
ADDITION
4.0WN9:' . I (Nam,2L ) J
~)~IC'
5. ARCHITECT (Name)
/'1e~ F-TNP
et'J{.//I/ .oS
(Address) (Tel. No.)
l-#-I'?:>;;;'" ~") rl~. tjLJ~-S8/
(Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY 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 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
buildin icial can revoke this permit for justHiuse. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed ins~ons.
X;.' /: GtI~ 'Hloqoo J:l 5r-;q- q~1
Signa'rilie license No. Dale
1ulex'\.ov.
Fireplace 0
Alterations [j
~
Septic 0
Addition [j
Deck[j
Finish Attic [j
let! do, 5 i..!:l!:,l
Re-roofing ~ Porch 0
Re-siding [j Finish Basement [j
SEATS
0{J n~~
7. TYPE 0 ORK
16. PROJECT COSTNALUE
17. COMPLETION DATE
~...R ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
D
K'{~5 /'JIL
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS [j PERCOLATION TESTS [j
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS [j
SURVEY [j
SETS
COPIES
:7 5.U{) _ (/?/
PLOT PLAN
D
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. II:
Park Support Fee ........................... It
SAC ......................................... ot
Collective Street Fee ............. .......... <1'.
Sewer Tap ................................... $
.
Permit Fee ........................... .... .... $
'it/. 7"'-
Plan Check Fee ............................. ~
State Surcharge ............................. $
Penalty ....................................... $
/2-)
Total Due ............................... 7 (p ,0 6
Paid 7rA. d 0 R.cei~}~o;.<?~ g'y 7
Issued Date f3//;/ q q By ~ /
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance With the City ZOning Ordt nce a~d may proce~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.
Pressure Reducer .......................... $
Meter Hom ................ ................... $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... <1'.
WaterTowerFee ........................... It
Water Tap ................................... $
Builder's Deposit ............................ ot
Other ......................................... .<1',
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City Planner
Date
Special Condilions ff any
24 hour notice for all inspections 447-9850
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