HomeMy WebLinkAboutBuilding Permit 99-1073
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS /, r; ? rJ ?
OWNER
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CONTR,
PHONE NO.
PERMIT NO.
99-/CJ73
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
~ FINAL 0 PLUMBING FINAL '0 GAS!,INE AIR TST
o SITE INSPECTION 0 MECH FINAL .' .J' ~ ~
~ ""u /'! ,
COMMENTS: , 7 d~ '
i!"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~. CALL FOR REINSPECTION BEFORE COVERING
Inspector: f;r::;. , Owner/Contr:
CAll 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
------......-----.-----.-------_._._. I
DATE RECEIVFO
B/27/~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
Permit No. 99 - / () Z"L
1. DATE
LOT
3. LEGAL DESCRIPTION
4
J~')o? ~ V~QuJ r<o
g~/-<{q
U-W _ RIS.o
BUILDING INFORMA nON
~. SIZE OF STKut.,;-rURE
(Height) (Width) (Depth)
ADDITION
2
/ J L- /1/110 v/ e:W
12. NO. OF STORIES
"LOCK
4. OWNER (Name)
Lo....~~
5. ARCHITECT (Name)
PID zs--z.sz.- 007-0
snr
13. TYPE OF CONSTRUCTION
(Address)
S~ =,( q&,v.,Q
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER
(Name)
(Address)
Fireplace Cl
Alterations a
Septic a
Addition CI
?O. t$OX /z..!3
lYeW P~~5(/5 ~ I
Deck 0 Ae-roofing ~ Porch 0
Finish Attic 0 As-siding 0 Finish Basement 0
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
6 QJ'-d.~
7. TYPE OF WORK
New Construction 0
~~~ G~J<JJ.-
Chimney (J Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
J hereby certify that I have furnished information on this application which is to the beSI 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
building Offj~evoke this permit fo~~",,,,. ,-..,.. j\:i....". w, . .... ."~wee thaI the city official or a designee may enter upon the property to perform needed inspections.
X ~'<" '-~---- ~ ~-d.rqer
Signature license No. Date
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE US"
BUILDING DEPARTMENT VALUATION
Side
MA TEHIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LJ PERCOLATION TESTS LJ
Front
Back
Side
USE OF BUILDING
.e'!;S r-t/ /e-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS LJ
SURVEY LJ
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H t M R
Division 1 2 3 4
Permit Fee ...................................!t
2~-zJ7J. dV
PLOT PLAN
o
S U
7</.7-:;-
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. 4:
Penalty ....................................... 'I:
Plumbing Pennit Fee ....................... $
1.2-r
Mechanical Pennit Fee ..................... $
Pressure Reducer .......................... $
Meier Hom ................................... $
Water Meter ................................. $
Sewer & WalerConnection Fee ........... $
WaterTowerFee ........................... $
Sewer & WaterPennit ...................... $
Water Tap ................................... $
BuUder's Deposit ............................ $
Other ......................................... $
7t,.,oc)
Total Due .............................. $
Paid 7(". 00 Receipt No. .310 O+-o
Date 8 (z. "7 / q <j By 1::JU..-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinahce and may proceed as 1equested. 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.
::~"~ f't~~~.fJJ.;.~.~~:1t Whe~ ApPrcJjd"
By s;IIIlJ:!:; 1''''fJt/(' Date ~n7/<t 1
I / I ( ,
Certificate of Occupancy
Issued
City Planner
0...
Special Conditio,ls if any
24 hour notice for aU inspections 447-9850
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