HomeMy WebLinkAboutBuilding Permit 99-1122
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULI!D
!,j-t..-'n I~:DO
ADDRESS
5~h1
CG j)M WcrJ/) Sr.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q9-11,;l~
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TIONAt))
~ FINAL ((f5/
o 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 GASLINE AIR TST
o
COMMENTS: ..YI () ItJ(S
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L SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOPf' CA~L FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
C19-/IZ2-
ADDITION
PO/NT
';7r/l1
pt/.o I
PID . ZS - 2/~ - t'l.3O -0 I
I
51(;q fi1m~f. ~e;~~i{9~~Sl.1
(Address) (Tel. No.) ;
(Address) (Tel. No.) '.
&n~ ~ S/J) t, W1-frJd(
. DIRECnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDRESS
54(;,Q
~EO/jewooo
S:T A./6
BUILDING INFORMA nON
11. SIZE OF STRUCTURE
(Haight) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT 4- BLOCK
..5/9NO
3
12, NO. OF STORIES
47H'
13. TYPE OF CONSTRUCTION
4, (JJ;R '/rI~
5, ARCHIT~'Name)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
~Wif
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-rooflng 0 Porch 0
Re-sldlng ~ Finish Basement 0
SEAT!'
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /9. 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 m . ned property and that all tructioR will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding offie' p or ' ,"hermore, I hereby agree th"/l?~rial or a designee may enter upon the proper1y to pertoe, niflrrons,
Signature License No. , Ie
17, COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
Cl ENERGY DATA
Cl
BUILDING DEPARTMENT VALUATION
r<:E~ /7/ /C..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS 0
SURVEY Cl
SETS
COPIES
z.- rzru . VU
PLOT PLAN
Cl
TYPE OF CONSTRUCTtON: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 7'-/. 7 s""---
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .............. ot
Sewer Tap ................................... 'I:
$
Pressure Reducer .......................... $
Meter Hom ........................ .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... ,ot
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
~'.'mbing Permit Fee ....................... $
. Permit Fee ..................... $
(..-1... r--
'f ...................... $
........... $
'ermlt w~"n:ned'1
Water Tap ................................... ~
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7 t;. 0 lS Receipt '1<"
Date ':;/9/"7 By
Ie application and accompanying documents is in accordance with the City Zoning Ordj~nce and may proceed requested. This document when
~mporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
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Dale
Special Condilions i1 any
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24 hour notice for aU inspections 447-9850