HomeMy WebLinkAboutBuildling Permit 99-1143
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULe?
.'
IO'1,.z.-1'1
AJ;
ADDRESS
~,;l;;;),-/ ~ ~
OWNER
CONTR.
PERMIT NO. 99 -/ /~s
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
(ll/FINAL
b SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~
0/'
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o G?:~N~ AIR TST
r '
,
~
~~
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.-/
COMMENTS:
"-
-".-
'c::~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR)1 CALL FOR REINSPECTION BEFORE COVERING
Inspector: Ih _ Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
_..~_._..._-"-'--_._.,~----_._--"-----------_...._-
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
at 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 ab oned property and that all nst ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
. 9 ic can revoke this it r' st e. Furthermore, I hereby agree that the city official or aJ'd~sij!lpe ma~nter upon the property to perform needed insp~ns,
X ~J / ' ~ ~"_ ') C!-/7-or'1
I / 1lfA/l h License No. . Dale -
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
9~7/9'1'
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
4:J()'t..I
1. DATE
t/L
Cj-/7-71
Pr-}6r f..eJ<e. ~I
PID Z-S- -300...002. - 0
3~
3. LEGAL DESCRIPTION
~ /lLlt""
I
,-v c./.;S
2.
BLOCK
LOT
ADDITION
4. OWNER
CrCtI CA,
5. ARCHITECT
I'A~/A6e
(Name)
~'-rDcS Ju_
(Tel. No.)
(Address)
S""..........
(Ac:ldress)
(Tel. No.)
(Name)
(Name) (Address). . (Tel. No.) h/.;l
k;r-e,,-, WcJ//-e- a;~~J,-.. ~'i 1m shult; ~~
. Septic 0 Deck 0 Re-roofing K" Porch 0'
Addition 0 Finish Anic 0 Re-siding 0 Finish Basement 0
6. BUILDER
7. TYPE OF WORK
Fireplace 0
Alterations 0
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
v V
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
Zr1fV.dV
USE OF BUILDING _ e.~...5' A/.It'
TYPE OF CONSTRUCTtoN: I II III IV V
OccupancyGroup A B E F H , M R S U
City:
Division 1 2 3 4
Permit Fee ................................... It'
7cf. '1r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I. Z.r
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9'1-/1.f3
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. PROJECT COSTNALUE
S;600,~
17. COMPLI::TION DATE
MATERIAL FILED WITH APPLICATlON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
L1
Plumbing Pennit Fee ....................... 'I:
Mechanical Permit Fee ..................... 'I:
Pressure Reducer .......................... $
Meter Horn ....... ............................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $_
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ............................... 7(,.cJ 0
Paid 7f1. ro ReceIP~t)i:> 3", 'ZA ,.
Issued
Date 4J;?/t; 'f By
ThiS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City zom" ~rdmance and may proceed ~ 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.
;:FirePlaceP:~;:~;.i:?itW~~1_
CertIficate of Occ/ancy
24 hour notice for all inspections 447-9850
Special Conditions it any
City Planner
Date