HomeMy WebLinkAboutBuilding Permit 99-1285
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
t., s- ~'s- - ? '(-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATlPN::> ~
FINAL I"O(>)
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(~~
DATE TIME
/ t5 -;)., /.I-j
!fer fJ~k&/
~ Cli.(!. "'-~
w-/c~f-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
':5(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
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
\D DO
-- j;!A TF Ri=r.i=IYEQ
5SlDD
CITY OF PRIOR LAKE
BUILDING PERMIT,
"/ fll'fln TEMPORARY CERTIFICATE OF
oel 't 0" \) ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99./2;;5
I
I
I
(DePth)
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE ALLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) It) -;2 7- tj 9
12,s'595. fn5g?r-658'f Jl,u-.bor 8&tc--h.
3. LEGAL DESCRf'PTlON
f-&
1. DATE
PUS[)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heig!1t) {Width}
LOT
BLOCK
I
PID
2.5 ~ "2~3 - C/.b.::Q
12. NO. OF STORIES
;2...
I
14/:t;'~r (Ncn~\.\J CE>m~~d;;-:+v A~m, IT...NyE-7cX3'f
15. ARCHITECT (Name) (Add'ess) / iNO.) ,l
61t~'1- (Name) 1 t '5 rjAd~fD 0,.. ~15)~OOfD
J'~-r 1 'ffJ IV. OCCUPANTS
7TYP~0~ WO~~ R,eplace! I.>~;ti~;' eo ~k 0 " Re_~:/;:S ?oreh 0 SEATS
New Construction 0' Alterations 0' Addition 0' Finish Attic 0' Re-sidlng 0' Finish Basement 0 16. 3PRO~,C. T/C~E',~E)
Chimney 0' Misc. ~ ;)'-{.,-",
IS. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. $? 90 Width Depth Yes No /;;J. - I 5' - '19
t hereby certify that J 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 agenl for
the above mentioned property and thsl 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 offfi8Yca. n f6Voke (ttis,p"m" . for just ~ Furt. hennare, I hereby agree that th8jity otf~l or ';. dps~ee may enter upon the property to perform needed ~ections.
X !/", )lIArV,", V1_'.tn "-2.0 ~'1/7'O /f)-;;;J, '/-9"1'
v SIgfl81'1" License No. Dale
ADDITION
13. Y"fE OF CONST~~ION
''<f. e-('oo!:, ( f1 <f
14. FLOOR AREA APPORTleNMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICA 1l0N
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PER COLA TION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
. BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~c:;
A/12-
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ----Z. c;tJt).lf[)
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 ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.'
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
itJ.. 75"
Plan Check Fee .............................:t:
State Surcharge ............................. It
Penalty ....................................... <t
25
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & WaterPermil ...................... $
This
By
i1d;ng ;:t~;t /"11' rzVq 1
I
Total Dua .............................. $ ,t? DO
Pa;d i~ ,00 Rece;pt Nc. .3f1J....L. 7
Issued ~ By .J'~ I
ms ;s to certify \t1at \t1e request ;n \t1e above applk:ation and accompany;ng documents ;s ;n acco,danca w;\t1 the c~:;on~n~ b:~ca a2 may pr~~u-;;;ed. Th;s 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 Planner
Dale
Special Conditions if any
24 hour notice lor all inspections 447-9~O