HomeMy WebLinkAboutBuilding Permit 99-1114
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCI;lEDULI:')
CA TE TIME
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A.I-
ADDRESS
/~/JY~ ~ ~ ?;Po
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
'LINSULATlON 0 SEWER HOOKUP
/.': FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: i1.rJ ~
I
99-111~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o G~RTST
y- I
~~
-
('7 (;/~
;/~~~)
~
-
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~.' , CALL FOR REINSPECTION BEFORE COVERING
Inspector: -ffi. Owner/Contr:
I
gALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INS/'iOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
___..~____.._. __~.__~___.__.._._..______,______.___~__~...____.___ --"-'___'"'0__._-----
~~
DATE RECEIVED
9/g/cn
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 al bottom)
LD:;!? l'l'f
j~~e;;-~ IJ~ ~
3. LEGAL DESCRIPTION
, ,
LOT
PID 25- '13/- ODS-()
BLOCK
ADDITION I'167ES -'1NO (3t10NOS
4. ~NER (Name) ..... tJ. (AddreS~ ~ c-r: . J (Tel. No.)
~ Zu~ /5t:Jtfb~~. (,!:l/'//{?-'I71J.r;-
5. ARCHITECT (Name) (Address) (Tel. No.)
7. TYPE OF WORK
New Construction 0
'l6gt ~ ~?JI', (TeL No.)
Fireplace 0 Septic 0 Deck 0 Re_r~;~~fls:,:?/'?I
Alterations 0 Addition 0 Finish Attic 0 Re~siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq - UL'I
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
OCCUPANTS
SEATS
16. ~~?~A~~
17. COMPLETION DATE
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 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 above mentioned propetlY 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
~Uildi ic;al ca~ revok IS ~~ermore, I hereby agre"1l'lJ1;'~';a9 ge~nee may enler upon the property 10 perte; 1Il99,;ons.
Signature . Licoose No. ate .
Amount Brought Forward .................. $
Park Support Fee ........ ................... $
SAC ......................................... $
Collective Street Fee . ........ ........ ...... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILD~G
~<;.
JI- / If'
?.f:::r'X':>. e>O
,
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV ()l.......
OccupancyGroup A B E F HIM l..A S U
DMo'" 1 'lJ 4 7'1.7S
Permit Fee ...................... ............. $
City:
Plan Check Fee ............................. $
State Surcharge ..................... .... .... $
Penalty .................. ..................... $
........
I.Z.'::.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $-
This ~ceflb~m~our Building Permit When Appro~q.,
By ~L/-- Date f -9;~7'7
Certificate of Occupancy
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Other ......................................... $
Total Due .............................. $ '7th. 0 0
Pa;d '7(". 0 0 Rece;pl N;l. Jt-t? g 2-
Date q -8 ..q '7 By ( -#>
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 01 Occupancy must be issued.
Issued
City Planner
Dale
Special Conditions ~ any
24 hour notice for all inspections 447-9850