HomeMy WebLinkAboutBuilding Permit 99-1218
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRW 11./3%'1
to 1...,oII! .
OWNER
PHONE Ne.
o FOOTING
o FOUNDATION
o FRAMING h
o NSULATION
INAL
i'lITE INSPEC ION
COMMENTS:
00b
L
SCHEDULED
hd~ Ar<-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
1"'-z.S~
Ar
qGj - I 2.18
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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CTION BEFORE COVERING
ner/Contr:
Inspector: _
CALL 447ks60 FOR THE NEXT
CODE RE
SPECTION 24 HOURS IN ADVANCE.,
OR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
s~~
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
ttt-fl-(!3
1. DATE
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
"'3~9
F;:1Lr- livE }./l
BLOCK / PID 2./:;-Z"='4- .00"1-0
T~ JI~ ~~O~=..
3. LEGA~ESCRIPTION
LOT -,
ADDITION C::> 7:l't A c:>,~
4.0WNERf (Name) 1_
6a.r ~le.<. il-ncUY~
5. ARCHITECT (Name)
BUILDING INFORMATION
1" SIZE OF STRUCTURE
(Height) (Widlh) (Depth)
/?,~r LA~. 1'1111
~5"37 Z.
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(A;lIlress) '\
(?~ )
(ACldress) -
(Tel. No.)
1./03' 0153
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
i,..(.Yl'~ ~$I("><<-I,~
(Address)
1~'iOQ !'r.-d ~
?t.'Iff>V,'{/f. #'1 ~
Septic [j Deck [j Re-roofing"'" Porch [j
Addition [j Finish Attic CI Re-siding CI Finish Basement [j
(Tel. No.)
t,,1Z-
ffl}- en C(5"
SEATS
16. PROJECT COSTNALUE
Chimney [j Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished infolTllation 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 entioned prope 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 cial can revok pe or just 6ijU FurthelTllore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
7n~ W-,-W
License No. Date
Pressure Reducer .......................... !t
Meter Horn ... .... .... .... ............. ....... It
Water Meter ................................. It
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ r (...... -
Paid 7 C, - , Receipl No, 3&>'"l-- 't 1
Dale Ie. (", {f'" By f2.0H
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Orclinan'ce 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.
6. BUILDER
7, TYPE OF WORK
New Construction 0
Fireplace [j
Alterations 0
x
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
A-Jz
,-.
USE OF BUILDING _/2.G-s
lYPE OF CONSTRUCTtoN: I II III IV V
Occupancy Group A 8 E F HIM
Division 1 2 3 4
Pennit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... ~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTB
17. COMPLETION OATE
FOR ADMINISTRATIVE USE
Back
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
'2-~c:;;O. r-
R S U
City:
Amount Brought Forward .................. <I'
Park Support Fee ........................... <1'.
SAC ......................................... <I'
Collective Street Fee ....................... $
Sewer Tap ................................... It:
$
"14."\.-;-
\ . '2.--,\
seWer&Wale:j;pe ?jJJ....... ..~..... .. $
Gas Fireplace P rm" .. ... .... ... ,II::
This Applicati eco G e it Whe~ov' /
By. e_,~
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850