HomeMy WebLinkAboutBuilding Permit 99-1147
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5L/.:?- 9
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4<'.1 ~ ,:
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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COMMENTS:
DATE TIME
Id~Z-z.-~~ A.I.
99-//,tJ?
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAJLINE AIR TST
)( , --,'
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~-
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
IlVSNOTl
'-'-~-'._''''-''-'''- -- ----...-..-------..-----...- "-- .-+.--....-..- ".____"U__.____._~____._._.__________
~~
-t M1410
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
q;rZ /97
.!-
I. White
2. Pink
3. Yellow
File
City
Applicant
DATE RECEIVFD
" 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
SI.f~9
Permit No. q 'l: - II tt.,7
,e,;
BUILDING INFORMATION
11. SIZE OF STRlJCTURE
(Height) (Width)
(Depth)
3. LEGAL DESCRIPTION
LOT 8 ~LOCK
1M?oot=.Sl/r6{,e;
-g~k.~ CltecLE
.:3
SE
12. NO. OF STORIES
ADDITION
If/us
PIC 2.5 - 0;::'1- 02-0 -()
2.'1/0
4. OWNER (Name)
- //rV + kitllBN fYJ.'!J 6tlS
.5. ARCHrfECT (Nam.)
k~;)
~J.'1 e"ltf.E. 1?L.
(Address)
"If If'O':'~9 2.?
13. TYPE OF CONS~UCTJON
r~ ,PO../-!
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER (Naruq)
/t1't')~/C"'" /$"/~~(j
(!D W7le19c'Jif 1M
(Addres~
I:/:;J.1j7 IW"'t.J,.Jr74v~:f'.
i:/Jte~tJl/.a, m,.;
(Tel. No.)
h',). ?() 7 6tn
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
7. TYPE OF WORK
Fireplace CJ
Alterations CI
SepticCl
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch CJ
Re-siding CJ Finish Basement 0
16. PROJECT COSTNALUE
t'. S/JtJ. (J ;
17. COMPLETION DATE
New Construction 0
Chimney Lr Misc.
a. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. FI. Width Depth Yes No
I hereby certify that r have furnished information on this application which is to the besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
th~ ~bove ~.entlOn.ed prope~~nd t.~.ll nstructlon will conform to all existing state an~ 10~1 !aws and ~i11 proceed in accordance with submitted plans. J am.aware that the
bUilding offiCial ~voke thiS pe for fJst ~se. F~hermore, J hereby agree that the CIty offICial or a deSignee may enter upon the property to perform...Qee~d mS98:lions.
7A1. C4t,uu/, - - , '':f&d .., 11 / T
X ./,1~ I IN .f.-_ "7...&I,<:;91r; t' 1'1
/Signature license No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
- BUILDING DEPARTMENT VALUATION
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
TYPE OF CONSTRUCTION: I " '" IV U;J
Occupancy Group A B E F HIM 4t
Division 1 -a 4
Permit Fee ................................... $
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION '2.,S"c:tO I
SURVEY
PLOT PLAN
o COPIES
CJ
USE OF B.JJILDING ~ h
I{Q~. J}/~
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
7./.7<::
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
/.2<"
$
PlumbIng Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ..... ..................... ............... $
Total Due .............................. $
Paid R.ceipt ~ "3 ~ 22 '1
Oat. 1-20-"it:; By (-lIS
Sewer & Water Permit ...................... $
:~'S Fi ,Ia~' ~~~...~~.:~~;,~i~~.~..:itrnz;rro~"
B _ ~~ _ ~~
. .
Certificate of Occ cy
Issued
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 Occupancy must be issued.
CityPianner
Date
Special Conditions if any
24 hour notice for all inspections 447-9B50