HomeMy WebLinkAboutBuilding Permit 99-1202
DATE TIME
. PRIOR LAKE
.CTION NOTICE liCHEDIllED /0 - 2.2.-9" A.'T;
.)DRESS 32 ( if ~ /KI.
.
OWNER CONTR.
PHONE NO. PERMIT NO. 9'7 -/ZcJ z..-
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
K tnr( ~
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o G~AIRTST
~ ,-
~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'12( FINAL
/0 SITE INSPECTION
------ ------
c/!!{/~ J
/
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR27CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
-----------------"--"-,~--------~-- "_.,~----,,_._--
~~
D/E,ED
10 / 't::},f
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Permit No. qq-/Z02-
..
1. White Fh
2. Pink Cit~
3. Yellow App.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
It) ~ / -'79'
2.SI~"~
3. LEGAL DESCRIPTION
5f*C/tle
-- .
/~4' r/
5~
,Ie I$D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
LOT
/3
BLOCK
.4-
PID
.4DO,J .
25-/72-- (J&.3-()
4. OWNER /O;;;:;e)
5. ARCHITECT (Name)
~T / ~ It <;)dceSSI
(Address)
LIt! /~I'I y~
13. TYnOFC~STRUCl!9'
/(~/'ZOd (
14. FLOOR AREA APPORTIONMENT USE
ADDITION
_., l/dSF-:{ ,1-// L(..5;
(Tel No.)
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
If ~'I">~R:/l'lI- ~r~....
1ft! 7-?o/ yo
Re-roofing P' Porch 0
Rs-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
6 BUILDER ~(}I
i (;#1r1~;;"J
Chimney [j Misc.
B. PROPERTY AREA OR ACRES
Sq.FI.
9. PROPERTY DIMENSIONS
16. PR~OSTNALIII=
7 c:::t:)'t).
110. CULVERT SIZE 17. COMPLETION DATE
Yes No /// ~~' 99
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
ns conform to all existing state and local laws and will pr~eed in accordance with submitted plans. I am aware that the
e. Furthermore. I hereby agree that the city official or a d~ne~ay enter upon the property to p~orm needed ~8Ctions.
<"YVl r/ ( .p / (J - / . ;7 9
License No. -- Date '
Deck 0
Finish Attic 0
SEATS
Depth
x
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.k'.~.r "q/..e
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS LI
SURVEY 0
SETS
COPIES
Z $()l). of)
PLOT PLAN
LI
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... !t:
SAC .........................................~.
Collective Street Fee ...".................. $
Sewer Tap ...................................!I;.
$
Pressure Reducer .......................... $
Meter Horn ........... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Division 1 2 3 4
,cf. 7 J
Permit Fee .................. ............. .... $
Plan Check Fee ............................. c;:
/.2-5
State Surcharge ............................. !I;.
Penalty .......................... ............. $
Plumbing Permit Fee ....................... $_
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... 4:
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /(O.<! C)
Paid ''1 t. . 0 0 Receipt"'. .;g" z, r ~
Date Idlt /1q By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning O~inanc9 and may proceed/s requested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
uilding Permit When ~pr9"Jdr..
Date ~/ I( 7 -,-
This
By
Certificate of ace/pan
CityPlannar
Date
Special Condilions ff any
24 hour notice for all inspections 447-9850