HomeMy WebLinkAboutBuilding Permit 99-1286
CITY OF PRIOR LAKE
INSPECT!ON NOTICE
SCHEDULED
ADDRESS
ll;C;u-
Cf'd- - 9 Lf
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNOA TION
o FRAMING
o ~SULAl:I9NA/'-C:"
J2f FINAL n <--v'!
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
('f /!:U' ~ 0
DATE TIME
/ t:f-~<j~j
'Ift-<-k?/ &a~
99-1,~ff ~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
V WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORKLP'LL FOR REINSPECTION BEFORE COVERING
Inspector: I/!:r- ( Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'-1 00
0< PR/O", LP
~~
~TFj:lFc;l=lYf.l2
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
eel 2'j OO'D
5~l.pO
L White
2. Pink
3. Yellow
File
City
Applicant
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUeD (Please Print or Type and sign at bottom)
1. DATE
Permit No.
9CJ- /2 9ft;
~,. '~~ (Nama) liS$'3 RvtdrasfJr. CZ9S-otYfD
ooif:n4 /3VNIS ul-7 k rfJN, 5.<:)3.'37
. TYPE OF WORI('J Areplace CI Septic CI J Deck [j Re-roofing4"" Porch CI
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-sidlng 0 J:lnish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. '1 tJ 0 Width Depth Yes No
I hereby certify that I have furnished informatIon on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authcxtzed agent for
the above mentioned property and that all con~~tion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~'kJ,ng o!c{:i~~~emvt ca!7j\:,l"Upr' I heraby agr.. fJ.~a j'Y3";1 0; ~/?a may entar upon tlla property to pe/~ n~J1'7~r
SignBlurj3} (' J Ucense No. Date
2. SITE ADDRESS
/'~9fJ ./-:592 + 1:.5'1'1
3. LEGAL DES(!RIPTION
q BLOCK {
/0 1:27- f~ ~
~,hDr !f,.."",c...h- p~
-
PID 25rZfaa - nnq-O
LOT
ADDITION
4"f7:R l (Nam~
- /" L:>t:> C LiC:)/n m
5: ARCHITECT (Name)
~ (J}ddress)
1/J'I/7V
(Aldr...)
IJ 5$"i")C.
tI?6 ""9863-
tr.r. No.) I
I
BUILDING INFORMA TlON
11. SIZE OF STRUCTURE
(Hei!1it) (Width) (Depth)
12. NO. OF STORI~
13. }iYPE Of, CONS}ljUCTI~NI'
K oft) t<> 06TS
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE R
33,075'. D
17. COMPLETION DATE:::
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Fronl
..ok
Side
Side
BUILDING DEPARTMENT VALUATION
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
.
USEOFBUILDING ~E.5 f1/Ji!-
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 7.....0 U.cro PLOT PLAN 0
TYPE OF CONSTRUCTION: I II Jll IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
74-.75;
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC m..............._.............._....... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer .......................... 4::
Meter Horn ................................... 4::
Water Meter ..................................It.
Sewer & Water Connection Fee ........... It
Water Tower Fee ........................... $
Water Tap ................................... <l:
Builder's Deposit ............................ $
Other ......................................... of'
Total Due .........._........_.._....... $--.JiA.O 0
Paid "'7 ~ .0 0 RacalP"3
Issuad' of:2.914t 14
Th~ is to ce<ti1y that tha request In tha above application and accompanying documents is in acco'dance with the c~:;o~ng ~:'y pr~ ,equa'Sied. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to "'" '" ,..,..,,,"'. Before occupancy, a Certificate of Occupancy must be issued.
S U
City:
Plan Check Fee ......................... .... $
Stale Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
J . 2.... c;-
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
This
By
........-............. $
uildlng ;:t':"]fJj7Yj41
CilyPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850
$