HomeMy WebLinkAboutBuilding Permit 99-1228
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
63'1{
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIONj AI
Jl!( FINAL /IAl"O"O r..z:v
o SITE INSPECTION
COMMENTS:
AJMr
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SCHEDULEt>
~ S-r.
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
Il~J.qj
99-/J.;( 'X
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
hORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/IlIA
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
~~
DATI=' RFt:FIVI=O
/~~?,
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No. c; q - / z..z.. e
I 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 h;) 9",t{ C,C?A/ A'/7 Y 5 r
3. LEGAL DESCRIPTION
1. DATE
~/S.o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
ADDITION /I? t::; , C-~
14. OWNER (Name)
/2.IU:;
5. ARCHITECT (Name)
BLOCK
~ I$OVA/.DS
PID ;z.5 -2.613 r /)0.3-0
"e<,RP2. .r
(Address)
K3</'c
L.tf?.vRLJ ~ J:-r
(Tel. No.)
13. TYPE OF CONSTRUCTION
/cCMIY 7$-,4lltN
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER (Nama)
(.,../I,:r...r r c/2N
C$~)M.
(Address) 711 . J
? /f::lO /3 -"Ulf,tv
/,?c,.;;r;o t//I/
DeckLJ
Finish Attic [j
(Tel. No.)
U-YhtJ)()Cf
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition [j
Re-roofin~ Porch CI
Rs-siding 0 Finish Basement 0
SEATS
Chimney LJ Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that r have furnished information on this application which is to the besl 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 local laws and will proceed in accordance with submitled plans. I am aware that the
building official can revo e this permit for just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed i~s29Ctlons,
X ......... //7-//-')'
Signature license No. Date
16. PROJECT COSTNALUE
~<;f7t?9~
17. cOMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LJ PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~ -o/'A:--
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
"Zs-c5)) _ rf?)
PLOT PLAN
LJ
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ............................... .... $
V
R S U
City,
Amount Brought Forward .................. $
Park Support Fee ..................... ...... $
SAC .........................................4'
-Jt./. ts
Pressure Reducer .......................... $
Meter Hom .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... :t
Total Dua ...............................< 7to.0 0
Paid 7'- -66 Recei o. 3~c/o '"
l~ed /
Date /O/"/'l'[ By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin'nce a d may proceed requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifica of Occupancy must be issued.
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I.~.r
Collective Street Fee ....................... <t
Sewer Tap ................................... ~
$
Plan Check Fee ............................. $
Sewer & WaterPennlt ...................... $
CrtyPlanner
Dale
Special Conditions W any
24 hour notice for all inspections 447.9850