HomeMy WebLinkAboutBuilding Permit 99-1047
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
~ 2.:00
/5889 F/iif:6/'70AlT
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
C/q- /047
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
o FINAL 0 PLUMBING FINAL ~ ,GAS LINE AIR TST
o SITE INSPECTION 0 MECH FINAL ~, ieOOP FIN/f L--
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L SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO,K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ffi \ Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
nATE RECEIVED
B/7-3/rt
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE ALLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12.SIT.E/~.DDR~bFl. ~ I J1
") A' A''"T rrp',,:?/nO.,? HI/fI',
I
ISLAIIID V/F.-W 4- 'V7I
NE / (N'r"..Jc ~ddr.ss) I j
'/ oe(}LL//'( /.Sii9 J-I'I'VAM.i'I##tlJIh),
. ARCHITECT (Name) (Address)
I f~:1~99
/IJ LJ.
RISD
3. LEGAL DESCRIPTION
q
BLOC~
PID
;?,C;-zt./.q ~ 009 - 0
LOT
ADDITION
(T.L No,) / /
WI? -v51J.?'
. ' -
(Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
. ~ ~/ ~ . -d JJ' @/-5/J'~
~ ,~~ WORK 11:e.o1'//j~1J ~ /1(jf:J~(fIJ :[:J.?Jf)/1~
New Construction CJ
Alterations CJ
Addition 0
Finish Attic 0
Re-siding 0
Finish Basement 0
I. White
2. Pink
3. Yellow
File
City
Applican[
Permit No. _Cf q - /Oij-L
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
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 heFebY 7';;' ~..:..Ihave furnished infonnation 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 a e me ioned property and that all construction will canfoRO to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:UiI ng offici /:;~::?pd:~' Furth.nno,., I h.,.by egree that Ih:!2ty ~ff~C~~ 0~d~(l9g)JlSWpon the property to P.rl~:;Ji~~CS
--,/~ -7 Signature License No. Date /
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Amount Brought Forward .................. If:
Park Support Fee ........................... ~
SAC ......................................... If:
Collective Street Fee ........................'1',
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ....... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... If:
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7/-.00 Rece;pI Ntt...:3 1-" / (;,
Issued '+" At // fl--3oL
Dale f!J/z.s~q' By /VJ/~
This is to certify that the request in the above application and accompanying documents Is in accordance with the City Zoning Ordlnanc'e and may proceed 6quested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to W" '" ..::.. ,...J. Before occupancy. a Certificate of Occupancy must be issued.
r
- SETBACKS: Required
Actual
Baol<
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
7Sfl U if?)
USE OF BUILDING
PES ,ql/L
PERMIT VALUATION
TYPE OF CONSTRUC110N: 1 II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
74.75
City,
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/. 2-~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
ilding Permit W'MfZLoft; 1
Date ~J '7
/
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
7& u U
24 hour notice for all Inspections 447-9850
Special Conditions ~ any
City Planner
Date