HomeMy WebLinkAboutBuilding Permit 99-1134
CITY OF PRIOR LAKE
INSPECTION NOTICE
"L:t~
Cf~
TIME
SCHEDULED
l1-r
ADDRESS .5307 Lew../ev. C:...
I
OWNER CONTR.
PHONE NO.
Cf't- tl!.4
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~.PISULATIO~
~~INAL
o SITE INSPE N
_COMMENTS: Rrn~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
b,
Inspector:
_ Owner/Contr:
/
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
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DA TJ:: RFr.F=ll'I=Q
9' //~9
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
'11-
Permit No.
Il-sl./
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
. r-"7 6"7 ~5'Ar lEt- ~;"C'_ h:::
3. LEGAL DESCRIPTION /
LOT
q
L,4;c.t5S IOC
"LOCK
ADDITION
4. OWNER (Name)
::TO).r'r<' A~A.",u-,,"
5. ARCHITE~T (Name)
I 1
DATE
9~.,t'h1
jZ/SO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
s- /-="
12. NO. OF STORIES
I
./'?/TNO K-
PIC ?5 -O.5~ - I)l')4-cJ
13. TYPE OF CONSTRUCTION
&::'W1'..c;tA'dC ~
14. FLOOR AREA APPORTIONMENT USE
(Address)
,-Ju7 kAlk.z~ ~?...k
.J
(Tel. No.)
<t Y7~ \0+7
(Tel. No.)
(Address)
6. BUIL~ (Name) . _,.; (Address)
t//~l1'o.r /7'/1<oo:"r/',_> l"r
f) - () 6' "LY(c./dh (i=: PI/I; S"
7. TYPE OF WORK Fireplace LI Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
(Tel. No.) ? 15. NUMBER OF OCCUPANTS OR SEATS
ff2.-'i?lJJ? 'rrL OCCUPANTS
LJ!o Jfl<ftt.~,~. -eO v '>" ~ SEATS
Re-roofing ~ Porch 0
Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
7',?OO~
17. CO{.P[ETION 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 infonnation 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 truction will confonn to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
building Offici~L~e . or' )Pbusyurthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X ---';'-'/"rr'~ ~-- 2cJr Cr/~/ ~
~. Signature UcenseNo.
Date
Sewer & Water Penni! ...................... $
~iPiAe7Y?~~.~. r ~~;I~I~~.;e:it~hen ~~.
B~ Yf): - Date ':t.. -/'1 77
v'"
Certificate of Occup
Issued
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUilDING I
f6. /tI/1?
I -
TYPE OF CONSTRUCTION; I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Pennit Fee ................................... $-
Plan Check Fee .... ......................... $'
State Surcharge ......................... .... :t
Penalty ....................................... $
Plumbing Pennit Fee ....................... ~
Mechanical Permit Fee ..................... $
FOR ADMINISTRATIVE USE
Back
MATERIAL FilED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
Side
Side
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO 01 ANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION L.<=.r-.t? _ <:::C PLOT PLAN 0
" S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
CoUectiveStreet Fee ....................... $
Sewer Tap ................................... $
$
")<{.7<;
1.2"'--
Pressure Reducer .......................... $
Meter Horn ....... .... ................. ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... t
7t..OcP
Recei~t1>k)-.... ~/. 2n7
By (-t:ff.2
Total Due .............................. It
Paid 7~. 00
Date "J -1'1-"1 f
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 OCCIJpancy must be issued.
City Planner
Date
Spec~1 Conditions if any
24 hour notice for all inspections 447-9650