HomeMy WebLinkAboutBuilding Permit 99-1097
DATE
1)-6-'7
/'/tfI~ ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULE iii
ADDRESS
Itc/o7
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ,--I/T)
!J FINAL "" ~-:::':.O \IV
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
0/1-
~L-fJ.
v '"
TIME
'19-/097
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEEO
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/WA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
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~,
QA TF RFr.J;IVFD
?/3/'91.
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 Type and sign ~t bottom)
1. DATE
q / 3/q1
I I
)Z/SD
12. 8rn: ADDRESS
\Lollar')
N""-LL",,,J {J '1,,1
3. LEGAL DESCRIPTION
"0
AI O/Z7HW'OO.o
PID _?<:;. l!:f:..1~_/)37- L
LOT
BLOCK
ADDITION
t':,NER ~e) o nn~_ (Address) ~ (Tel. No.)
IIpiJ:Y1 C.J(f..u"..~.J 4 ~rJ- 2,/::25
e11Rld i t~
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
7. TYPE OF WORK
New Construction 0
Fireplace a
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Rs-roofing? Porch 0
Rs-siding 0 Finish Basement 0
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-1091
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
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. 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 abo:ie m . ';oned propeny and 'hal ell construeUon will conlonn to all ex;st;ng stale and locallews and w;U proceed ;n eeeordanee w;th subm;tted plans. I ,am aware that the
bu;ld1ng off; .. can revoke th;s !"Inn;1 for just cause.. Fu"henn~. I hereby agree that the dty off;dal or a des;gnee may enter upon the propeny to perfotJJj,,,",**,~' .
X , ~ ~.-/\.... ((< " 1.0..-/ .,. /;
~ Signature License No. . / D e
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z >?IV. cru
USE OF BUILDING
..e6> .4/ e.....
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS
LJ ENERGY DATA
o
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS 0
SURVEY LJ
SETS
COPIES
PLOT PLAN
o
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... ~
Sewer Tap ................................... $
S
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R S U
City:
74. '7 r
I. ?-J
T1bing Permit Fee ....................... !C.
"'al Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ........................ .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... <t,
'r Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $_
7(,.00
Total Due .............................. $
Pa;d 7 {, .00 Reee;pt ~~:-!" 0 7 0
Dale '1/3/99 By ~
Ie application and accompanying documents is in accordance with the City Zoning Qrdfnance and may proceed akkequested. This document when
. temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
,tt ..(~I~I~~.i:,;;11pft?~
24 hour notice for all inspections 447-9850
Special Conditions ~ any
Date