HomeMy WebLinkAboutBuilding Permit 99-1177
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCH~ULED' /~ -/~-99
A.t-
ADDRESS
/6ZZ3 /'Y"~ ('~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q9- //77
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
xl FINAL 0 PLUMBING FINAL 0 GAS~~ ~TST
/0 SITE INSPECTION 0 MECHFINAL ~ ~
COMMENTS: ".(/d-+--/ -/ O<J ~ ~.
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111.
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:s::o:.ECT 7,CALL FOR REINS::~::/::n::FORE COVERING
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
5~~
D.An:RI=r.I=I'~.Il
9P?,#1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicam
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No. 99-/1'7/
2. SITE.l9!?RESS
/.-:;- ~ ~-3
1. DATE
10> 7-7?
e/~D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
~
12. NO. OF STORIES
LOT
BLOC~
PID 25-//,5- /JOA- 0
ADDITION
4. OWNER
130 fJ
.;t!l/J:;p!-TlON
14. FLOUR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6 BUILDER ;?~~ ~~::r
7. TYPE OF WORK Fireplace 0 Septic 0
New Construction 0 Alterations 0 Addition 0
11'":> C{ S- J"),J/. (Toi. No.) _
7 :;J (...-'T/'K"~?' ~
till 7- :;27'ti?o
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Deck 0
Finish Attic 0
SEATS
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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~p and all. construction will conform to all existing state and local laws and w~1 proceed in accordance with submitted plans. I am aware that the
building offi99an rev is it for just cause. Furthermore, I hereby agree that the city official or~~nee may enter upon the property to pe~ needed inspections.
X n_ ~ Lf'J"'h \f" t'" ~.;",)7. '7 9-
, '" t::::./ Signature . . License No. - ,. - Date
r
'lIJ6~OJECT COSTNALUE
'f /$C50 ~~
I n. COMPLETION DATE
I /O~;2'-7cr
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Skle
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS Ll PERCOLATION TESTS Ll
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
L.er -0/' /L
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
Z.>zrV . CIV
PLOT PLAN
Ll
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
. Division 1 2 3 4 'to 74 7)
Permit Fee ...................................
City,
Amount Brought Forward .................. $
Park Support Fee .... ................. ...... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. <l:
State Surcharge ............................. $
Penalty ....................................... $
/.~~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer&WaterPermlt ......................4:
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid '"7 lb. 0 U Rocoip~.
Issued
00'0 q h.1 /c 7 By
This is to certify that the request in the above application and accompanying documents is in accordance with the City zonin( O~in~d may pr s 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.
Gas Flrepla e P.ermit ....................... $
~~i uilding ~:1:iI w2Jft~#i
7~.oO
3;U:.o
CRy Planner
Date
Special Conditions W any
24 hour notice for aU inspections 447.9850
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