HomeMy WebLinkAboutBuilding Permit 99-1168
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCH=DULEa
ADDRESS
/(s/{ n~ M.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ,_ /&)
INAL ,N ~ VJ/
~ITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
0/,
DATE TIME
J~- l'<:f~
? 9- //,{JI
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASllNE AIR TST
o
~~
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~ORK 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.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
--_._~._---~"-----.._--
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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Pink
Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THAU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No. _Cl9f.i.// fL~
2. SITE ADit:fs: / /.p
3. LEGAL DESCRIPTION
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(Tel. No.) I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
LOT
BLOCK
PID 2540/' otJ6 ~()
l'115nEs AN/J 8(J(JJ'I/~
4.~ER I~' (Neme). ~d'jS.) ::'V'ttl6S
_10m .' nO ('J() , '\ . fYIlJ ?ts_
5. ARCHITECT e) (Address)
ADDITION
13. TY~ OF CON~':;RUCTIO)J
(( JJ - /1/Jf?-r
14. FLOOR AREA APPORTIONMENT USE
6. ~ yj~;_ \ J 'J ~~dreSS) rA 7-. (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
~ DUOS CflnJintC/l f";}., . . 0fJ r ;;?ffl- &39') OCCUPANTS
4(';1)(0 1.1;-::f{J'I [fi/J!JIlOfl/4.JA/M IYIN SEATS
7. TYPE OF WORK Firepl ce a Septic a Deck a Re-roofin~ Porch a
~~~~:;~"'~::. 0 Alterations 0 Addition 0 Finish Attic 0 Re-sidlng 0 Finish Basement 0116. P~;~~~~ 7~~UE0?
:~P=tOPERTY AREA OR ACRES I :i:t~OPERTY DI~e:~:IONS I :~~ CULVER::IZE i 17. CiOE'z?7E 9J
I hereby cenify that I have tumished informetion on this application which is to the best 01 my knowledge t"'e and correct. I also cenlfy that I arrlthe ownerCthonZed agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submined plans. I am aware that the
:Uild' ial n ravo s ermit o0't cause. Furthermore, I hereby agree that the ci~i~,;::r~~~2ter upon the property to perto~~? ~9ns.
l./;:!../J r- -'YJ~~ . _ License No. oite
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
USE OF BUILDING .
f2",,-. ~ / rc
J
SPACES ON PLAN
PERMIT VALUATION
35 f"l"'Y) . <9- eJ
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: i II III IV &;>
OccupancyGroup A B E F HIM (j S U
Permit Fee ...........~i~~~~~.~.~...~..~... $ ZSO ~ 00
~
....Jt--. ~_--=~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
11 _ f;'Y)
-.
1~ 1,I.,Ct,u.
p= +...\~pl-.......
Quo\-<> fp,
Amount Brought Forward .................. $
Park Support Fee ........................... 'I:
SAC .........................................4'
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Horn ................ ................... 'I:
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... 4'
Builder's Deposit ............................ $
other ......................................... $
Total Oue ............................., $ . ?,In]. 50
Paid .;307. s;f) Receipt No, .3" 2 c;;-o
Date q/U..../'f'f' By ~
This is to certify that the request in the above application and ;;.,,""., ,,",,,,.,ing documents is in accordance with the City Zoning OrdinanCe and 'may proceed as~quested. 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.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Perml ....................... $
mes u(r S..lI"'--Permit When ~..Erov~.a.
~Date 4-Z.2.~. I
~ -
Issued
City Planner
0."
Special Conditions if any
24 hour notice for all inspections 447-9850