HomeMy WebLinkAboutBuilding Permit 99-1191
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULED /ol~
ADDRESS
/tSI/, F~ w.J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
? '7- /J'I /
.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING _ 'n 0 WATER HOOKUP
o INSULATION ~If'il 0 SEWER HOOKUP
151 FINAL IV> ...., \(!) 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
(}Jr
('~~
X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
./IL(!..
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
;n I~
-.-,.-.'.---__.__ ""__'___"'~_'_'_~__'__'__~"_'__'_"_""___..._m'_",_________~_.__________"_.___.______.__.
6~~
DATF RFr:l=n,'F~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
9/zt7/91
Permit No.
t?9-/ /9/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Pont or Type and sign et bottom)
~ TV71n\1ffllml\
3. LEGAL DESCRIPTION
1'17g3 }11
Heav+!rl1l..)f)M A-o+S~z.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
'LOCK
1'1.3, ""... AAlo L'S/)(jNnS
PID ;!!5-&f0/- ()OS-o_
4. OW.lIf () {'(1
5. ARCHITECT
tirh n
(Name) f!S'
6~~ ~. wrr(;tnld10~4DO~-~ 14e sO't,-a8;)Z3-:n
.._ "j),'2(lltt~v M u f>S"I[)("
7. TYPE OF WORre ' Fireplace [j Septic [j Deck Ij - Rs-roofing 0 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic LJ As-sidlng)( Finish Basement 0
Chimney CI Misc.
lLoloQ (~~ I aU :.:;, (fOr N<:J
1n1\\"PlS.. /'1\1)\ &WQ.,IM:- a15-DLl'lT
..." ::VPE OF CONSTRUCTION
~~jjp
14. FLOOR AREA APPORTIONMENT USE
ADDITION
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
8. PROPERTY AREA OR ACRES
Sq.Ft.
16. PROJECT COSTN:J#j
(I, /Xl), -
1'0. CULVERT SIZE 17. COMPLEIION DATE
Yes No II /1 Jqc;
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 1 am the owner or authorized 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 submitted plans. I am aware that the
~uildwp;~e'Jj;A.1e " '''Pb;;J2J;AC8use. Furthermore, I hereby agree that thYJrtJa1lJ!:!i!Jnee may enter upon the property to perto~3 "MS'
$iIjIltrre ~No. oJ.
19. PROPERTY DIMENSIONS
Width Depth
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS t:I ENERGY DATA t:I
PILING LOGS t:I PERCOLATION TESTS t:I
PLANS & SPECS 0 SETS
Front
- BUILDING DEPARTMENT VALUATION
USE OF BUILDI'iG
~A./K-
j
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION Ll.ooC!).~
SURVEY
o COPIES
PLOT PLAN
t:I
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permil Fee ................................... $ J 1<./. '2S""
Plan Check Fee ............................. $~ L,'3 .6'i
t>-SO
CiIy,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fea ....................... t
Sewer Tap ...................................4'.
$
State Surcharge ............................. $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... It
Meter Horn ................................... <t
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... It
Total Due .............................. $~q~. e4-
Paid Receipt No.
Date By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as 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.
I g Permit ,en ~prov,.
Dete -2 '-Ii
Penalty ....................................... $
Mechanical Permit Fee ..................... $
Sewer & WaterPermlt ...................... $
City Planner
Date
Special Conditions if any
.
24 hour notice for all inspections 447-9850