HomeMy WebLinkAboutBuilding Permit 99-1042
~ TIME
CITY OF PRIOR LAKE 9: 3(:)
INSPECTION NOTICE SCHEDULED
,
ADDRESS 11./137 $~ &.cA Tit-
OWNER CONTR.
PHONE NO. PERMIT NO. qq -/04-2-
o FOOTING
o FOUNDATION
o FRAMING
MSULATION uf1
INAL 1(JyI
o SITE INSPECTION
COMMENTS: Reef
~~/~~~
( ~ <:::;I,k.. .'\
\ ~
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
,
L.<J t ,.I e.,-
----
/
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: t?1--. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANC~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNon
Ii~~
DATE RECEIVED
~/ZO/rr
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'~7zo/99
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9?-/ot/z-
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
/~/.37 SHI7DI/ e~/l(!.,1-/
7Jet-
N6
/215.0
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
,10/ ~ n;:!; /1# t::) L3I'J t/ AI .oS
PID 7F;-//J.j- f2/'J"/- 2....
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER (Name) . (Address)
,,~ ~X- '7dV\ n ~fL. aT
Iso ARCHITECT (Name) (Address)
6. BUILDER (Name) (Address)
(Tel. No.)
'(;tj 0, /(~ l/~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic D
Addition 0
Deck 0
Finish Attic 0
Re.rOOfin~ Porch 0
Ae-sidlng 0 Finish Basement 0
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 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
~Uilding ~ can revoke T~iU~. Furthermore, I hereby agreethet the city official or a designee may enter upon the property to peqrn :,0' 1~7ns.
r r Signature UcenseNo. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
R~..s /1/12-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2507). dV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
S U
'/~, 7r
City:
Amount Brought forward ..................:t
Park Support Fee ........................... ,of:
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ......................... .... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit fee ..................... $
/.z-;;-
This
By
g Permit wheryApp~ov a
ate ~/ZO -,
,
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Sewer & Water Permit ...................... $
Total Due .............................. $
Paid ~y;.OO Rece'ptNo 3(,009
Issued -
Date ~ Z-O/t?q By-::JfL--
This IS to certify that the request In the above applICation and accompanying documents IS in accordance With the City ZOnJJg Ordl;(n~ and may pr~ 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.
'7(,.00
CityPtanner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850