HomeMy WebLinkAboutBuilding Permit 99-1064
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
IJ.- B-Cfi
ADDRESS 3f../73 U/~~ .~LlT.Nzd
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99- IOic.;
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION .' /J
Illi FINAL P-,D<4(j)
o SITE INSPECTION
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 GASLlNE AIR TST
o
COMMENTS:
n I ~
( ) t\
dJ2.tL jc.fo
t~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
/f~wner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
"1/5
-,---_.__._.-.._._~_._,---_._-~-
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Sq. Ft. Width Depth Yes No
1 hereby certify that , have furnished ""~,...""..., 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 nd that all construction will conform to all existing state and local laws and will proceed in accordance with SUbmined~lans. a~ i~e that the
~Uilding official can :voke '~hermore, I hereby agree that the City official or~,mo/e property to perla ~/q4S'
." ....., Signature Ucense No. D6.te" .
DATE RFCEIVED
6/zw /.CJ.c;
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Tyee and sign at bottom)
I 1. DATE
~1LfJ~SS( I} iJ}"o/) Ut?/!/71d/Jj- j/
3. LEGAL DESCRiPTION
,.eISQ
LOT
BLOCK
7re/le.T 0
PID 25-/07- (')04 - [)
RL-:5 #36
4.mR ~ li/(Narn.e)tf. Zft. .. rr:
.JLlfZ) ~ .qct21k)h~.AIA'
~AR H T (Name) (Address)
tu. ff~ . o:&'?/.?1 rLh t1S-k.,. n-U).5J #44
6. BUI 0 R (Name) r# . {j (Address)
ADDITION
.
(Tel: I'j(>.)
tftJJ -/7-5/
(Tel. No.)
=f9/ -rJ/t/
(Tel. No.)
7. TYPE OF WORK
Fireplace LJ
Alterations a
Sept;cLJ
Addition 0
DeckLJ
Finish Attic LJ
Re-roofing 0 Porch LJ
Re-sidi~ Finish Basement a
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99- /004-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES co<.
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECTCOSTNA~
"7s:Vt 1-
17. COMf:1LE1101\1 DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. ct:
Park Support Fee ........................... "
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
- SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
/[500. -
USE OF BUILDING
,eG,<; ~/2-
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City,
7C/. 7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... t
/.25-
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS 0
SURVEY LI
SETS
COPIES
PLOT PLAN
LI
Plumbing Permit Fee ....................... ft
Pressure Reducer .......................... $
Meter Horn ................................... $
Water MeIer ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. . '7&. () 0
~~h/;/"fq' ReceiptNo. ~O2."'l
ffl- . '76 (/T) By d://~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed al'iequested. 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.
Mechanical Permit Fee ..................... <l:
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Th~'S . 7! ~e :(oI!nluilding Permn Wh'l!!ApPP'~r'lll-n
By ~_ '.,J.f:7 Date BIZ-fa '1''7
/
Certificate of Occupancy
Issued
24 hour notice lor all inspections 447-9850
Special Conditions if any
CltyPlanner
Date