HomeMy WebLinkAboutBuilding Permit 99-1176
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL..ED
ADDRESS
/L/4//J5
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION @J
FINAL
~ SITE INSPECTI N
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~J)ltJ~
DATE TIME
9'7-//7(",
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT we ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: 0- t Owner/Contr:
I
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
.... -'--'+-"-'~--"--"--~'---'--'---
(Name)
S~ (1uf
7. TYPE OF WORK Fireplace ~
New Construction a Alterations a
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS \100 CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that , have furnished information on is 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 m~~~~ 1:/ tha~ 0 ill ,'//:,nlorm to a" .~s,;ng stat. and ,,,,,,,, laws and will proc.ed In accordanca with submltt.d plans',J,am aware that Ih.
~Ulldlng Off~~ tf1]Ifij fit 'T ~.. h J1 or., I h.r.by agree that the Cl'i}fft' ~ dfign.. may .nt.r upon the plOpeny to perto'f!(71Y7pecllons,
Signalure . - License No. . f Date
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
19~7/?7
-l>U.o
DATE RECEIVED
9,fr 7/rn,
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
/44-t)..3 S /IO~ ott...rJ.
3, LEGAL DESCRIPTION
4-
Itl<( O~ rJ.J1L i~
J =.1 I(pd..K,A
(Name) , I
LOT
BLOCK
6
PID 2S--?j5 - (j~7-0
/J. -k, SA'NO P7: ~"-t
~ ~ fl/~~I:;J~_(,.S()S
ADDITION
4, OWNER
(Addr.ss)
II/t//) <.
(T.' No,)
5. ARCHITECT
(Address)
6, BUILDER
(Address)
(T.' No,)
fPnr; ~ Sf U/'l.-'!J.f"/-fd-1Jl
SepticLJ
Addition Ct
Deck 0
Finish Attic LI
Re-roofing 0 POTch ("I
Re.Sidlng~ Finish Basement 0
1. White
2, Pink
3. Yellow
File
City
Applicant
Permit No.
99-//7h
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
OCCUPANT~
SEATS
16, PROJECT COsTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Fronl
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
~f5?IV ~
USE OF BUILDING
~ 4//C-
,
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTlDN: I II III IV V
Occupancy Group A B E F HIM R S U
0"""'" 1 2 3 4 7<1.7f
Pennit Fee ................................... $
Amount Brought Forward .................. $
Pal1< Support Fee ........................... $
SAC ......................................... It
Collective Street Fee .......................!:t
Sewer Tap ................................... $-
$
City:
Plan Check Fee ............................. $
State surcharge ............................. $
I. ... (
Pressure Reducer .......................... !:t
Meter Horn ................................... $
Water Meter ................................. $-
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Du. ...................,.......... $ 7 h . ci.J
Paid ib.dO R.C.,PINo,3r,:~.0
Oat. ~/J.7/'lS' By ~/ /
Th~ is to certify th.t the request in the above appllcaUon and accompanying documents Is in accordance with the City ZOni~g Ordiof..nc.and may proceed aJequested, Th~ 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.
Penalty ....................................... ~
Plumbing Pennlt Fee ....................... $
Mechanical Pennit Fee ..................... ~
Sewer & Water Permit ...................... cr.
~;i'Wkt~~~.i:~itw.r!2~t;
Certificate of OOcupa/cv7
Issued
City Planner
24 hour notice for all inspections 447-9850
Special Conditions it any
Date
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