HomeMy WebLinkAboutBuilding Permit 99-1083
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCt'.EDULI'D
ADDRESS
S7eQ
CroS5~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATIO 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
o SITE INSPECT N 0 MECH FINAL
COMMENTS:$i rJlN6
lo;:';jqq ~:(it)
Sr
tj'q-lorJ
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
A,~ L /~o~ A~
pl~ ~ ,.d-L, .~.:I:=-
(-- ~- -M~~
'- ~
I'-.J:'. _ ______
./
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK,t!LL FOR REINSPECTION BEFORE COVERING
Inspector: fJ+ ( _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
--~"'--"--'-----""-~-'-^-'-----'-"-~--'-^'- ~-,----
~1
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2, P;nk
3. Yellow
File
City
Applicant
Permit No. el? -/ t233
1';731/99
MN~&5?~
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 0 ' i.
,~1?9 CrtfSandra JI. Sf, rHorU1KC
3. LEGAL DESCRIPTION
~
CA(l-PI~ 1L.oc.8' J>5: Mp.
4. OWNER (Name) J' /' - '- (Address) /) (T~1. No.)
Bnan y- .....JUl/eb'IOS on (SflflIt-tiSCUJ{)ve W'7- f,Jj04
S;o;daa C~f/Sf. Co) /~, {;giS Br,t<otnSf-N.,
PnDrlA/::.6, M
7. TYPE OF WORK Fireplace 0 Septic 0 Deck LJ Re-roofing 0 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic LI Re-Sid~ Finish Basement 0
LOT
BLOCK 3
ADDITION
5, ARCHITECT
(Name)
BUILDING INFORMATION
11, SIZE OF STRUCTURE
{Height} (Width) (Depth)
12. NO. OF STORIES
PID
"l. ~ - Z<fq -057-0
13, TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Tel. No,)
41f7-JCXJI
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 me . ned prop an at n ru~tion will conform to all existing state and local laws and will proceed in accordance with submitted plans.
:uilding 0 (A( (p it t s. urthermore, I hereby agree that the city o",-r~rignee may enter upon the property to perto
ignature
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING --R~
/
A.IL
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
This
By
CnyPlanner
17. COMPLETION DATE
UcenseNo.
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LJ
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS CJ
SETS
COPIES
2.';-<=0 -
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ",,,,,,,.,,,,,,,,...,,.................. $
Collective Street Fee .......................!t
Sewer Tap ...................................!t
S
74-.7.,,-
I. Z":;
~~~
Pressure Reducer .......................... $
Meter Hom ........................ .... ....... $
Water Meter ................................. $
Sewer & WaterConnectlon Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... ~
7",_ ~
Date
Special Conditions if any
24 hour notice for all inspections 447.9850