HomeMy WebLinkAboutBuilding Permit 99-1030
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.
DATE TIME
JJ-1-19
ADDRESS ;'SI~51t\
sk LA /'/ E.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING /AI 0 WATER HOOKUP
o INSULATIO,N.-" JU:.d.\t}I. 0 SEWER HOOKUP
)!:( FINAL ,u """"I .. ~~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
()~
-
~~
~?- /030
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
/1~ Owner/Contr:
Inspeclor: .
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
TNSNOTl
--..-.--.-..-.-------
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
dU4.1 L
k1106;
White
Pink
Yellow
File
City
Applicant
Permit No.
?9-/(J.?{)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST eE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
<6"\ \'b "R~
PUSD
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. S(TUl1Rlt1n
3. LEGAL DESCRIPTION
14--
SA;-./.D
'S~~ L(\. (\. f.
.
LOT
=iLOCK
5"
12. NO. OF STORIES
PID
7_C:;-?P~- 079-0
ADDITION
Lf71+
\~\W>
(Address)
13. TY
Po f 1\/ /l;;:
~~~-\7')hCA
5. ARCHITECT (Name)
(Tel. No.) _L 14. FLOOR A
In. rlf_, L,4<:"~rlu.':rJ
(Tel. No.) I
.1
6. BUILDER (Name)
hne/era4o C /IJ II-
B\.\.<::t(" A~\~ A-lOS
7. TYPE OF WORK PQprace 0
New Construction 0 Alterations 0
Chimney~~.....r iCl.. .f,
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS
Sq. Ft. Width Depth 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 thai I am the owner or authorized agent for
th~2ff mention rty and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
:u7~i'\tQn ~ vok . e . for just cau'j Furthennore. I hereby agree that the city OH;ci~ ,~~qay enter upon the property to perto* l~d i<j9ions.
Signature license No. Date
(Address)
(Tel. No.)
~d.-"B\,~
15. NUMBER OF OCCUPANTS OR SEATS
~~ tf{\f\
OCCUPANTS
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re.roofingj1k.. Porch 0
Re.siding~ Finish Basement 0
.
SEATS
16. PROJECT COST~LU~ ~
19 /-1hc...l_
17. COMP~TiON DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILEO WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
L'..F3 4/ ff
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
COPIES
SURVEY 0
Z~. ot)
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A
Division 1 2 3 4
s U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... It
Collective Street Fee ....................... .It
Sewer Tap ................................... $
$
Permit Fee. ..................... ......... .... $
74. 7s
Plan Check Fee ................. ............ $
State Surcharge ............................. $
/. -Z- C-
Penalty ...................... ................. ~
Plumbing Permit Fee ....................... $
Building ~:t;'il '7!ftf1
Pressure Aeducer .......................... $
Meter Horn ................ .... ........ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... It
WaterTowerFee ........................... $
Water Tap ................................... ,t
Builder's Deposit ............................ $
Other ......................................... (:
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Total Due .............................. $ 7(".00
Paid 76.(['0 Receipt No...35AQ"';'
Issued _ ~ _
Dale Pr!tq/tiq By ~
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City ZOnln6 ~d may proceed Jrequested 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.
CnyPlanner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850