HomeMy WebLinkAboutBuilding Permit 99-1148
DATE
TIME
:!>~
_,u~.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~kj?1
ADDRESS
$53 j5/KC,qrvooO
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'79'- 1/"-8
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP@DFIREPLACEFINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL S I 0 / Her
COMMENTS:
.~
b
C f!~ ~~
-
/
'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOft CALL FOR REINSPECTION BEFORE COVERING
Inspector: If ty \ _ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
&~~
~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-//cl8
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
S~ 53 1? ,'l'cJ... t.dttnJ
1. DATE
1-Jo - '19
PUSD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTI9N
LOT 4t BLOCK
...99NO
14. OWNER 'D (Nrme)
.pQr-..,..,)~k
15. ARCHITECT
6. BUILDER
ADDITION
C f'1\ $..<=i
7. TYPE OF WORK
New Construction LJ
(p
p" IN-'-
12. NO. OF STORIES
PID 25-2()5- 0'" 2.-0
/I\J.I?I
a
P.'('.CL'AJOn . -Od.:Xn
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
13. TYPE OF CONSTRUCTION
(Name)
(Address)
SL5"~
(Address)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
K.e-f:/~a~ MUlttiC rJSOO Dffn J r'tt ':.~;rJ ~~rCh rJ
Alterations LJ Addition LJ Finish Attic 0 Re'sidin~ Finish Basement LJ
SEATS
16.PR9~CT~l:~ALUE
<(~ eL
17. COMPLEl ON DATE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS r~~' ~~~:;~~7 ;iL~
Sq. Ft. ;:):::J. .:')~ Width Depth Yes No
I hereby Eertify that 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 above mentioned property and that an construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offic~ revoke th~t for just cause. Furthermore, I hereby agree that the city official or a desi nee may enter upon the property to pertorm needed inspections.
X AfGf+-1 ( ,L.O :,;- . ::2 J (] _'" 9- ;J /I _ 90
, i7" kignatuM Li sAo. Date 1-,
SETBACKS: Required
Actual
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
Front
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS rJ ENERGY DATA rJ
OFF STREET PARKING PILING LOGS rJ PERCOLA nON TESTS rJ
SPACES REO. PLANS & SPECS rJ SETS
SPACES ON PLAN SURVEY CJ COPIES
PERMIT V ALUA TION z.- <;(5lJ ffl./ PLOT PLAN rJ
RES hl/L
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S u
"7f.,>>
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... 4:
Plan Check Fee ................................
I. \..,\
State Surcharge ............................. $
Penalty............................... .... .... $
Plumbing Permit Fee ....................... 4:
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................ ................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... 4:
This
By
it.......................4:
BuUding ~:t';;t wo/~fr7
Paid
"7&.60
.y(, z..3O
City Planner
Dale
Special CondiliOlls W any
24 hour notice for all inspections 447-9850
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