HomeMy WebLinkAboutBuilding Permit 99-1106
DATE TIME
CITY OF PRIOR LAKE ~4-~
INSPECTION NOTICE SCHEOULED A.I
.
ADDRESS /430'0 LOIS AVe
OWNER CONTR.
PHONE NO. PERMIT NO. o/9~ /10 ~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL ~ GASLlNE AIR TST
o MECHFINAL (~~/OI..J1
COMMENTS~ k ~
~
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN ;>j:Y'?/rJtl
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) BUILOING INFORMATION
2. SITE ADDRESS ,c.iL f' lit hO, K.ISD 11. SIZE OF STRUCTURE
/43[:0 r. rjC /1- ?- (Height) (Width) (Depth)
3. LEGAL DESCRIPTION 12. NO. OF STORIES
LOT 5 BLOCK PID 25-/22.- o 05 - ()
BOULJ/.NS' 3""0 13. TYPE OF CONSTRUCTION
ADDITION H/JN~~ I? /Jill/- .
4. OWNER ~ (Name) " (Addre01 l)/(y ! k (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
<. J5tehrn /4...3[[; If/f :> '7
\.....'>fi'& C. L ~'k~ L -)/---
S. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
J--;UJe/O (J./I tV '); /71} r!, {iI/I . coLl'JC.. ?:2/-- if?~ 2-,_f OCCUPANTS
~-)//::' 0u 11//1 q L /I.../ti2/< ,.1.j IL' -.55'1[; (. SEATS
7. TYPE OF WORK '. Fireplace CI SeplicCl Deck 0 Ae-roofing 0 Porch 0
New Construction 0 -11 AlterationSD Addition 0 Finish Attic 0 Re-sidi~ Finish Basement CI 16. PROJECT COSTNALUE
Chimney 0 Misc. a,~/./k) gJ/-{J -
8. PROPERTY AREA OR ACRES I:' PROPERTY DIMENSIONS 1,'0. CULVERT SIZE 17. COMPLETION DATE
.~
Sq. Ft. Width Depth Yes No ,/
-
I hereby certify that I have fumished intonnation 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 and that all construction will conlonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building ~:n reyoke th~H7jtkJ/ r:: cau_se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perlonn needed inspections.
.J' '-/1..,//(11/ /. ) '//UA ) ,9/7"1 .!ff.~7/1'9
/ S,id)a'lure License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
Actual SOIL TESTS 0 ENERGY DATA 0
Front Back Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
4/ ..e.. SPACES REO. PLANS & SPECS 0 SETS
USE OF BUILDING RE;S SURVEY 0 COPIES
, SPACES ON PLAN
PERMIT V ALUA TION PLOT PLAN 0
TYPE OF CONSTRUCTION: I II III IV V Amount Brought Forward .................. $
Occupancy Group A B E F H I M R S U City:
Division 1 2 , 4 7~ Park Support Fee ........................... $
Permit Fee ................................... $ 7~ SAC .....,........,.,.....,...,.,...,.,...... $
Plan Check Fee ............................. $ Collective Street Fee ........".........".,$
/. 25"' Sewer Tap ................................... $
State Surcharge ............................. $ $
Penalty ....................................... $ Pressure Reducer .......................... $
Plumbing Pennit Fee ....................... $ Meter Horn ................ .... .... .... ....... $
Mechanical Pennit Fee ......... ......... ... $ Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $ Water Tower Fee ........................... $
Gas Fireplace Pennit ....................... $ Water Tap ................................... $
~~~~fpg~:.~mitWq~~1"f Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 'JIm to
- -~'rtificate of Occupancy 7(P,d{) Receipt l)lp. 3&070
Paid
.uad 9hlqq )/ f /j{
Date By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance afld may proceed ~ requested. This document when
signed by the City Planner consmutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner Date Special Conditions ilany
~7
ue~;It' 0 ;UIJ 1 .
i 7-1,00
DATE RECEIVED
---_._~.._.__..._._-----._--_.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
99-I/oh
Permit No.
24 hour notice for all inspections 447-9850