HomeMy WebLinkAboutBuilding Permit 99-1214
TIME
DATE
1~"3'''l'l
"'ell>
CITY OF PRIOR LAKE
INSPECTiON NOTICE
SCHEDULE,D
~T
ADDRESS.!I/JJ1 Od<.,~
CONTR.
OWNER
'1'1- 121 c.J
PERMIT NO.
PHONE NO.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
~OUNDATION
RAMING
o INSULATION
o FINAL
o SITE INSPECTION
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C.oMMENTS: ~ I
/"b. 0 tt
a~
/
/
/
-/wORK SA
o CORRECT
o CORRECT
/ ,
CEED
REINSPECTION BEFORE COVERING
owner/Contr:
Inspector: ,
CALL 7-9860 FOF, THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
QUlREM 1VTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTt
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~~
nATF RFr:I=IVI=Q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
ItJ/si~9
Permit No.
Qq./"-/4
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12, SITE ADDRESS \ J
J.././nld IJ J Ilhrttl:it -.SF
1. DATE
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
lOT ? 4.'1. to
BLOCK
PID
'l~roor -050-0
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
ADDITION
1!liJ(ftJ..
5. ARCHITECT
}N,.~e)
'I::if) :5e.
(Name)
(Address)
4//J! oI.fl ,Aa l nfO .:51, Sf
(Address)
(Tel. No.) C
LjI./7-7//h
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction ['J
Fireplace ['J
Alterations ['J
Septic 0
Addition 0
Deck 0
Finish Attic 0
,
Re-roofing" Porch 0
Re-siding 0 I Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney ['J Misc.
18. 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 abov 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
building ic; an rOle;." qa"l/(ju:;a;e, Furthennore, I hereby agree that the c;ty omcial or a des;gnee may enter upon the property to peiJ'l5"! ~ections.
Signature LICense No. Dale
17. COMPLETION DA fE:
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FilED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
Ll
USE OF BUILDING
J
;Lt::'S '" / F..
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PILING LOGS ['J PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PERMIT VALUATION
"'2-~C::O~ '
PLOT PLAN
Ll
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H t M R
Division 1 2 3 4
Permit Fee ................................... $
s U
City'
Amount Brought Forward .................. CI:
Park Support Fee ........................... ol::
SAC ......................................... ol::
Collective Street Fee ....................... $
Sewer Tap ....................................It
$
74.1"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
(.2.-..:;'
Certificate of Occupancy
Water Tap ....................................'t
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $~I" ....
Paid 1 ~~ .- , Receipt No. 'P
Date rO 1-.:;/11 By f2-0fd-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance ~nd 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.
Pressure Reducer .......................... <I'
Meter Hom ................................... t.
Water Meter ................................. <I'
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... .<1'
Plumbing Permit Fee ....................... $
Mect1anical Permit Fee ..................... $
This Appli
By
I /
When f8:~
Issued
GityPlanner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850