HomeMy WebLinkAboutBuilding Permit 99-1140
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULED
A7.
ADDRESS
~'iS Ic.'\?'
't-l7-rl
/ t:J)tf>vJ i!10fl~
OWNER PP('~!-
PHONE NO.
CONTR.
PERMIT NO. CJCf - II L{ 0
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING W 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~INAL 0 PLUMBING FINAL
/0 SITE INSPECTION 0 MECH FINAL
COMMENTS: K:o(5r;-
~1 (-~
-
~~
\.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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I
"-:;..,. " ~
. 1..
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-
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WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ ~ Owner/Contr:
~L 447-9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
\9. PROPERTY DIMENSIONS 1'0. CULVERT SIZE
Width Depth Yes No
ormation on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for
and t all constructio ill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
is pe t for just c s urthermore. I hereby agree that t;Ci'{ Otay a..,s~ z;y enter upon the property to ~::"J!~~p~ons.
~.".."" d c,,",,,, No. """ .
~~
OAIF j::u=r:J:'I\I~D.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
9~te/<rf
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
19~i6'~r
12SITE~K6S?
,
L~a-u
Ie/sO
;/)/-/J:-e
,
3. LEGAL DESCRIPTION
LOT :f BLOCK "2- PID 2~-O 83 - d33-c)
ADDlTlON () iR .e. .f: It;;; ce- e c:r /S-r
4.0WN}fo ;,),Na'1.) Prt ~;dreSS) l./ L{ 7B~NO/ If r 13
5. ARCHITECT I (Name) (Address) (Tel. No.)
6. BUILDER I~J?
7. TYPE OF WORK
New Construction 0
tM1'1k(e.;/Add'~..r
u-P (T-:';~ () 155~
/
Re-roofing tv" Porch 0
Re-siding LJ Finish Basement 0
Fireplace 0
Alterations 0
SepticLJ
Addition 0
Deck 0
Finish Attic 0
Chimney D Misc.
lB. PROPERTY AREA OR ACRES
Sq. Ft.
l. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
c;f-IIt.(O
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Deplh)
12. NO. OF STORIES
13~7~/PION
1.( FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
17 ;hDMPLETION DATE
'1 - :lS- -9 7'
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICA nON
Amount Brought Forward .................. $
Park Support Fee .... ....................... $
SAC ......................................... $
Collective Street Fee ....................... ,If.
Sewer Tap ................................... $-
$
Pressure Reducer .......................... $
Meter Horn ....... ................. .... ....... If.
Water Meter .................................4'.
Sewer & Water Connection Fee ........... <t
WaterTowerFee ...............................
Water Tap ................................... $
Builder's Deposit ............................ <t
Other .........................................~,
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
? m ,(17...-
USE OF BUILDING
,e es ~ //ii?-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Permit Fee ................................... $
7'f'.i5
Plan Check Fee ............................. $
(. "2.. ('"
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~~:,~f~;:t~ltW?"~q-7
Certificate of okpancy
Issued
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
-7(;.00
Paid '1 (;,. 0 ~ Receipt No. 3& "2,(&
Date q!tIP/ H By ';{kL...-
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 /s 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.
Total Due .............................. <l::
24 hour notice for all inspections 447-9850
Special Conditions ff any
City Planner
Date
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