HomeMy WebLinkAboutBuilding Permit 99-1266
SCHEDUL1:D /oj~q.4. T.
BqS:S WOOD c.,; e..
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~:5 4L0
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
99- /2 foro
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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COMMENTS: rIM ..2 ..~ ~_,_c ~
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c1wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~,
CLOSED DUE TO
INACTIVITY 8/30/01
Inspector:
OwnerlContr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
s~~
DATE RECEIVED
/o/zo/q1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
/0 ,:)tJ~9T
2. SITE5:.~ET:f b
.
B['L;7~oe>c1
&-z
,t:.fS9
3. LEGAL DESCRIPTION
9
.3
yY/c..-L Ol.A.JS 3.eo
/1) () (Address)
I ~evri~ sS' '7h
BLOCK
PID 25- 110- Oz./- r)
LOT
ADDITION
4. OWNER h (Name)
Ii 11 l'"
5. ARCHITECT (Name)
B (Tel. No.) I
~lPaJJ "/>
(Tel. No.)
(Address)
6. BUILDER (Name) ~ (Address) l/ 3 US DItR.c/-.jLeL No/"'
7. TYP~~,"If,C,aceo '~S~{; Deck 0 Re'roofing~ If ~~~? w
New Construction 0 Alterations 0 Addition 0 Finish Attic [j Re-siding 0 Finish Basement 0
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
q9~/Zhh
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIEL
13. r;p; Zs::;t:f"ON
14.fc~;;-R AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
/fEATS
~R~~ALlJE.
17. COMPLETION DATE
/0 -,;2.79" 9'
Chimney ['] Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumishe 0 ation on this application which is to the best ot my knowledge true and correct. I also certify that 1 am the owner or authorized agent tor
the above mentioned property a that construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding Offill c 1 ~~ cause~_ Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
( ~ture License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
R.ES ~//t.-
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F H J MAS U
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Division 1 2 3 4
Permit Fee ................................... $
Amount Brought Forward .................. lI:
Par1<: Support Fee .... .... ................... <t
SAC ......................................... $
Collective Street Fee ....................... <I:
Sewer Tap ................................... <t
Pressure Reducer .......................... $
Meter Hom ................ .... .... ........... <I:
Water Meter ................................. $
Sewer & Water Connection Fee ........... <I:
Water Tower Fee ........................... <I:
Water Tap ................................... <t
Builder's Deposit ............................ I\'
Other .........................................1\'.
Total Due .............................. $ 7&. 0 0
Pa;d 7Gr.() V Rece'pt No .7;(, 44-9
Issued Date Id/v/Ii<;' By 1J/lL- /
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance WIth the City ZomngOrdlnJnce and may proceed .t:q~~ 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.
City:
"/{. 2. (
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ............................... .... .... $
Plumbing Pennit Fee ....................... $
I. ?r
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
Gas7il/l;;j' eITt1; ........
This B
By
r
Certificate of Occupan
......... $
uildin Permit When Iopr1v .
Date IO/Z-O "Ie;
I -
City Planner
Date
Special Conditions n any
24 hour notice for aU inspections 447-9850
$