HomeMy WebLinkAboutBuilding Permit 99-1040
1J.-Ff9
/(~r/ ~ a.., Srv
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHlf~ULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION _ _ 0 SEWER HOOKUP
7f FINAL"(6...,,,( 11- 0 PLUMBING FINAL
o SITE INSPEC'TION 0 MECH FINAL
COMMENTS:
o If.
ck~ ,!d5
DATE TIME
99 -/090
o EXIGRADIFILLING
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
Inspector:
/lLVt
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
--~-_..,_._---_._.-...__._--._-----
.- ---..-.--------------
H 15
~~
&. D~ROECEI1;a._ CITY OF PRIOR LAKE
dl &-- 1</ I BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. c;p:f~ /04-0
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
I 'i~ Zd -'1?
BUILDING INFORMATION
11. SIZE OF STRUCTURE
{Height} (Width) (Depth)
2. SI1E 1P~SS
/@99/ ~-V~~
~e
3. LEGAL DESCRIPTION
7-8 'LOCK 3/ PIDZ5~/.3.3-(}3'i-n
.5P,eIN6I LI9K:.6 /l)wtJSHiP
5/eA'n,...//J'.SS)
c;;/
12. NO. OF STORIES
LOT
13. TYPE OF CONSTRUCTION
ADDITION
4'iJ1r/p ;:;;/
(T.1. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Na-me)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
~
Re-roofi 9 Porch 0
Re-sidi~~ Finish Basement LJ
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
x
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yas No
plication which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
ill conf to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
use rther.. e, I ~~!ij"ee that the city official or a designee may enter upon the property to pe ."', :.:-~~
l;:G.", .~~ S< _ "-79>
License No. Date
17. COMPLETION DATE
ignature
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Bad<
Side
MATERIAL FILED WITH APPLICA nON
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
EES /'I/.e...
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
7. 5 00
TYPE OF CONSlRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City,
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................_.. $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
'It/. 7)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/.'Z.-J"'
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Sewer & Water Permit ...................... $
:: :replace B:,,~...~J~:'~i~~-~-.~. 'g1 ~~rrJ,~q
By 'f'1>pP Dat. tI/ '1
Certificate of Occupa4 I
Other ......................................... $
Total Du. ..._.......................... $ 'Yt.:.O 0
Paid "71~. 0 (J R.ceipt "0. ;;Sro O() -;
Issued /'
Date 13 ;Vi tj q By t/;lffi-..
This is to certify that the request in the above application and accompanying documents is in accordance with the City ZoninrfOrdinlnce arid may proceed J: requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificat{;, 'Occupancy must be issued.
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850