HomeMy WebLinkAboutBuilding Permit 99-1178
CATE TIME
ADDRESS
I J.-7-'r~
s?7{ ~ ~o-rA.5.~
SCHEOU' ;0
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR,
PHONE NO,
PERMIT NO,
79-1/7R
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING JiiD WATER HOOKUP
o INSULATION . :t\ 0 SEWER HOOKUP
)!I FINAL /I.l ';;...( It 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: OfT
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ftP/'--owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
Ql~
------_. ..-.__._"--~--' _._-_._-,_.,--
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.Q4.TC ~Fr.I=IVFQ
9/27,Nr
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
2. SITE ADORESS
&?6 t""..4/p~/.,/~/ ./(/Ll,6..-c r/?
3. LEGAL DESCRIPTION
~.r-
LOT
/ Yl BLOCK 3
~>OIA/~ ~/DqlS
PID
25-ZQQ - 0'-19-0
/~,
13. TYPE OF CONSTRUCTION
7. TYPE OF WORK Fireplace 0
New Construction LI Alterations 0
Chimneyo Misc. J{ ,W,f~~
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify 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 all construction will conform to aU existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
bUUdi~A~ revoke this permit for just cause. Furthermore, I here~y agree that the city official ora designee may enter upon the property to perform A88ded' _"'.' I~.. .8.
X ~-_.- .n?~ ?~/7-?,
p ,- - Sig~e License No. Date r
ADDITION
4. OWNER (Name)
////#LE mcy,E/1
(Address)
.rfJ9? CH/l/J_',Uw /l /J r//
(Address)
5. ARCHITECT
(Name)
6. BUILDER
(Name)
(Address)
SepticLJ
Addition 0
Deck 0
Finish Attic CI
Re-roofing tJ-- Porch 0
Re-siding II Finish Basement 0
16. PROJECT COSTNALUE
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 99 - /OfJ
1. DATE
'7 -/7-7;'
PUD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Tel. No.)
L/q7 7609
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING _ ,ee s ~/ /Z.....
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Permit Fee ................................... $.
74. 75
Plan Check Fee .... ......................... $
State Surcharge ............................. $
Penalty ...................... ......... ........ $
/, t.. <r
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Rreplace Permit ....................... $
;is~on JC01)t{ur Building ~:t';it W;'~'1io/tt
p~- , I
Certificate of Occupancy
Side
MATERIAL FILED WtTH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY LJ
SETS
COPIES
2.s()2)~~
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................,................., $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Horn ................ .... .... ........... $
Water Meter ................................. <I:
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... <I:
Water Tap ................................... $
Builder's Deposit ............................ .'f.
Other ......................................... <I:
Total Due .............................,. 76,0(/
Paid 7? .0 () Receipt '10, :.s- (, z. cQ I
Date t?/t.-'f /Ii'? BY)Jv.--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordine(nce and may proceed Is requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows coostruction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Issued
CUyPlanner
Date
24 hour notice for all inspections 447-9850
Special Conditions ff any