HomeMy WebLinkAboutBuilding Permit 99-1194
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3795
mCJ . - I
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
/[f' SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
10 - 2.-"Z-- 'j1~
A :r:-_
~
Jf-,
19-//;;L/
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
,; G~fAIR TST
~
~c:o
. ~.. ~
V/lP~~y
COMMENTS:
./
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Woyf' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~_ Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
C!9,//9t!
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 j 7'1 s /V1w <; h. ~+.
1. DATE
Q,zQ-9Q
12./ ~ D
BUILDING INFORMATION
1 L SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
/
BLOCK
/Sl.JMJD VI~
(Address)
-s7 q ~ /IIOV/J.. <;!".
2-
jsr-
PID
25 -11/-3 - tJU;-i?
5. ARCHITECT
(Name)
I/o. <:<;rn
(Name)
(Address)
(Tel. No.)
tf,/7 - 8':;>q7
(Tet. No.)
13. TYPE OF C~STRUCTION
r-er{)nr
14. FLOOR AREA APPORTIONMENT USE
ADDITION
4. OWNER
/'1 ;/6
6. BUILDER
(Address)
/ '2..'\....17 /If,'LQlkfAvt 5,
A MUlL",./) g..:/J,'{\Cj UI\{rw.f06 /?......'I1H,'/I-r.. . ~>)37
Septic 0 Deck 0 Ae.roofin~ Porch 0
Addition 0 Finish Attic D As-siding 0 Finish Basement 0
(Name)
(Tel. No.)
707-{;"t5'Cl
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace 0
Alterations D
SEATS
New Construction D
16. PROJECT COSTNALUE
/'5;200-
17. COMPLETION DATE
Chimney 0 Misc.
18. 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 property and that all construction will conform to all existing state and Jocallaws and will proceed in accordance with submitted plans. I am aware that the
building Qffj9fi1 ca~ ~ke this permit for just cause. Furthermore, I hereby agree that the city official or a .designee may enter upon the property to perform needed inspections.
X .K:-~ -U:>1t6r~?/n "k2_Q-qO,
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
..e.€0 #/ /t...-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS [j
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTlON: r II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. It'
Pan< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
?~7S
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
I.e.-I
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Hom .................... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7~. ~ 0
P.,d' 7t..dO Rece'p~!.J ~,,7.-7(J
Issued
Date "l /:~f)/4 r; By .Ii.
ThIs IS to certify that the request In the above application and accompanymg documents Is m accordance With the City ZOnl~ Ordmance and may prOCeed/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.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
CRy Planner
Date
Special Conditions if any
24 hour notice for aU inspections 447-9850