HomeMy WebLinkAboutBuilding Permit 99-1285
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
t:, ') 9S' - >? '(-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATJpN;> ~
FINAL (",,-0(>)
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(~~
':5(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
DATE TIME
/0 -,J/l-j
/fer fJ~~/
&~(!.~~
9Li-/c~1-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
- _..'--_.._--~~.,._--~
\i, 00 DATE RFGEIVED
5'6(00
CITY OF PRIOR LAKE
BUILDING PERMIT,
'"I rllrn TEMPORARY CERTIFICATE OF
{lei 'l t.1l ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq~/Zf35
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
1. DATE
If) -;27-~9
;J,., 1" ):Jo r 8 eq c.. h
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Widlh~
2. SIZ 595 ~ 5g 7 'f"" 65" 8"f
3. LEGAL DESC~TION
f ~ BLOCK I
'HA{2P'OI2... ~E.A(',B
4',fktR . L If'.(a"le) C (Add~~
/'~r I/~\.\J Dn?/'J1()l\\
15. ARCHITECT (Name) (Address)
6. BUlL1t (Name)
71f!0;t~~
PUS/)
{Depth}
12. NO. OF STORIES
A
PID 2.5-"2"3- ()Ib-O
I
(T~. N.9.6' - 9a 3t
iNO.) I
l t "5 dAd~s:Jff 0,.. ~fS)-OOf'tJ
!SOfY\SlJ: tle. .JY}N* 553$7
Fireplace n Septic 0 Dlck'O Re.roofing' Porch 0 SEATS
New Construction 0 Alterations CJ Addition 0 Finish Attic 0 Re-siding 0 Finish Basement a 16. PROJECT C~TNALUE}
Chimney a Miso. 33~ 1::i't......"3
B. PROPERTY AREA OR ACRES 190 PROPERTY DIMENSIONS /10. CULVERT SIZE 17. COMPLE nON DATE
Sq. Ft. g;' '0 Width Depth Ves No 1;;2, - J 5" - 77
I hereby certlfy thai I have furnished information on this application which is 10 the best of my knOWledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and S811 construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
budding offi'ia can ,~vokell>iSr!f'" . lor just ~ Furthermo",. I ha"'by agree thatthelity~ffldal or '!. ~s2nee may ante' upon the property to perform needad ~actions.
X. 11"1.,"\/\/ Vl~ ~DL:5q/7'U /0-;;)."/-9'1'
v Signa ~ license No. Date
FOR ADMINISTRATIVE USE
LOT
13. WE OF CONST~!ION
I~ e-l^oot:- I (1 ~
14. FLOOR AREA APPORTIeM.1ENT USE
ADDITION
As~tIJ ,
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SETBACKS: Required
Actual
MATERIAL RLED WITH APPLICA nON
SOIL TESTS
o ENERGY DATA
F"""
a
Back
S~.
Side
BUILDING DEPARTMENT VALUATION
I OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V ALUA TION _z..':> () u. 6t)
PILING LOGS 0 PERCOLATION TESTS LJ
PLANS & SPECS 0
SURVEY a
SETS
COPIES
USE OF BUILDING ~c:;
AljL
,
PLOT PLAN
a
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
Amount Brought Forward ..................:t
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Hom ................................... $
WalerMeter ..................................'t
Sewer & Water Connection Fee ........... <I:
WaterTowerFee ........................... $
Water Tap ................................... of:
Builder's Deposit ............................ It
City:
7b/..75
Plan Check Fee ............................. $
z5
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..... ................ $
Sewer & Water Permit ...................... $
"ding ;:I;'''70n fz,,/q 1
I
This
By
Other ......................................... $
Total Du. .............................. $_-'7&" DO
Paid 7~.OO ReceiplNo. 3("J.-l~i
Issued ~ ,.J'~ 1
This is to cartify that tha 'equest in Iha above appl<ation and accompanying documents is in aceo,dance wrth tha c:;on~n? &:~ca a2 may p,::.z;::W-:;;'d. This documanl whon
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 01 Occupancy must be issued.
City Planner
Date
Special Conditions ~ any
24 hour notice lor an :..",..-.~..~..i 447.9~O