HomeMy WebLinkAboutBuilding Permit 99-1112
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /6- 2..-Z- -") i' A. r.-
ADDRESS <32?7cJ '111~ ..J;-,
OWNER CONTR.
PHONE NO. PERMIT NO. 99 -II I~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
"'Q: FINAL
/0 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 GAS LINE AIR TST
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COMMENTS:
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
ih,
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
DATE RFCEIVED
q/f3/q~
CITY OF PRIOR LAKE
BUILDING PERMIT,
.TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
7'- aD
..---.
1. White
2. Pink
3. Yellow
File
Gry
Applicant
k',N0'].,-
Permit No.
'tq-lll~
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
3~?O /ll'.f)./<;L Yf.
Iq:7~~
Ii! ISlJ
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
2-
/'Sf.....
12. NO. OF STORIES
ADDITION
BLOCK
VIE- vJ
/
1ST
PID 25, 1I.t) -llO'l.-e
LOT
4. OWNER (N1me)
:1~1 ,Rp,,,
5. ARCHITECT (Name)
(Address)
)'?71J .#\IV<^ ~J...
(Address)
(Tel. No.)
/.I7'7->S~1.f
(Tel. No.)
13. TYPE OF CO~TRUCTION
I' e rr!p- ,
14. FLOOR AREA APPORTIONMENT USE
6.BY'LDE~ (Na~~.
N>w"' ,.." tJ""/tI.'1I$
{l/lItrtAclvs
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
(Address)
n. "1-'77 /l/ol: 4&1 ,411(. S,
f?,lifMv//1L
(Tel. No.)
~P7-
6954
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
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 tor
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...9'ficiat ~~oke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~--..er ">-0/...:"';'3 g-, '1- 7-C} 4
Signature License No. Dale I
1~ PROJECT COSTNALUE
-' ~ '/l'/>-
,(?VV
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
USE OF BUILDING
fi.2 '3 ,
'"
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION 'L., ~(') C~
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
.4 /~
. /
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
SURVEY
PLOT PLAN
o COPIES
o
S U
City:
Amount Brought Forward .................. ~
Park Support Fee ........................... ~
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7l./.7b
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plurrtllng Permit Fee ....................... $
Mechanical Permit Fee ..................... $
.
Pressure Reducer .......................... $
Meter Horn ........................ .... ....... It
Water Meter ................................. $
Sewer & Water Connection Fee ........... II':
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ It'
Sewer & Water Permit ...................... $
Issued
Other ......................................... $
Total Due .............................. $ '7(,.0 0
Paid 7(,. 0 0 Receipt No. ?{;, O~ (
Date 7-8 -99 By (:J<
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 as requested. 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.
Permit Wtwl Apgipved).. 4
Date _"I - l'T 9'--+-
City Planner
Date
Special Conditions ij any
24 hour notice for all inspections 447-9850