HomeMy WebLinkAboutBuilding Permit 99-1031
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDUL~
,0-1"1-91 A.r.
ADDRESS
15 532- J~~ Ao.e,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99 -/03/
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
5 FINAL 0 PLUMBING FINAL 0 G~~AIR TST
o SITE INSPECTION 0 MECH FINAL )r ~I
COMMENTS: J?~ ~ ~ ~
f
(/ ('FL!ge--~~
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . OwnerlContr:
fALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~~
QA TI= RI=r.I=IVFQ
fJ//9/'l1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-1031
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLEO IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE AOORESS
/ S S-") L...-
1. DATE
q-(~~9q
ADDITION
2 D BLOCK
/.sf- fiND
S'i/r",^- Art.-
2-
vlDN
,J~
,;.Z/ so
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
3. LEGAL DESCRIPTION
LOT
12. NO. OF STORIES
PID 25 -/<!-3 - tJ39~ 0
14. OWNER 1111 ,(Name) /J I
/'J/ll.{I-L /...fJIA..pIS€^
15. ARCHITECT (Name)
6. BUILDER (Name)
It)'lrtf,.C.....,, O,,:kA;1IJ
COA,f{D.-CrBlS
7. TYPE OF WORK
(Address)
,.1)<;"3'1- 5fvl:NL Ave
(Tel. No.)
13. TYPE OF CO~TRUCTION
/.NtJ/lr
14. FLOOR AREA APPORTIONMENT USE
JSI
(Address)
,
(Tel. No.)
(Addre~s) 1'- L J r
f'L'l.v('J NI <0 .... T ftV( ),
tJlAfASYI'/~
(Tel. No.)
707-C'1'{4
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
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 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 aod will proceed in accordance with submitted plans. I am aware that the
:ulldlng ~ ;;;pe this pennll 'or jus, cause. Furthennore, I hereby ag'ee tha' t~o;~q; ahgnee may ente' upon 'he property '0 perto~~~~:'r~ns.
/ Signature License No. Date
16. PjIOJECT COSTNALUE
, tf.. 6f?O-
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPlICA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/21-:S H/ L-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2m. IYV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
CIfy'
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC """"...."""""""....,.......... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
--;4.7 S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
1.2,.S-
Mechanical Permit Fee ......... ............ $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Sewer & Water Permit ...................... $
:'k~:;,;;"~7
I ' ,
Certificate of Occupancy
Issued
Other ......................................... $
Total Due .............................. $ -;6,. dO
Paid 21P. {ru Recelp' \'jpn sa 00/
Datel1!tqjqq By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni~g Ordi~ance and may proceed Il 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 ff any
24 hour notice for all inspections 447.9850