HomeMy WebLinkAboutBuilding Permit 99-1288
CITY OF rRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
!o)q~
V--17
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULA~I _r---
~ ~~NAL 001
o SITE IN ~TION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~
~
DATE TIME
If? -/~ f./- j
,) I ;d
7/./ ti,LUCV .{;)fO{/-Q/
I
C;' y'- / rJ.-f' ~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
,..
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contc:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
, 7 ( . OL>
~~v
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
'1 ZONING COMPLIANCE
OCI Z EIIT'llAND UTILITY CONNECTION PERMIT
15TE.a'J.CjCf
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12'S7;~QE~ -J loSC(l
3. LEGAl DESCRIPTION
L4-
/-h r bJ(
I
PID Z5- ZG,3 - a 14 - C
fAI(Ae)L
'PusO
LOT
BLOCK
o
14. OV;~R t/Name)
rui Oy ('(wYlmunih I
ADDITION
(Address)
l'tS,<::ilu
1)IJr/~4fY O~
5. ARCHITECT
(Name)
(Address)
6. BUILDER
A;?lcC
r "\1.,'
c..Y,'\. ,.((1
7. TYPE OF WOOK
(Name)
I
,I
(Address) (Tel. No.) .
1/52;3/2u.pPPr:. 2Cf5-Cd-fc
KII(Vl,Slll/ll; (hI\[ \"'?~1
Septic 0 Deck 0 Re.roofln~ Porch 0
Addition LJ Finish Attic 0 Re-sidlng 0 Finish Basement 0
(Tel. No.)
z:, 'ole 0
I. White
2. Pink
3. Yellow
File
eit)'
Applicant
Permit No.
qq-/Zft/o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STO!jS
13t!::t ~ CONS(!!()T!)f 5
.. . J C1..
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... ~
SAC ......................................... Of
Collective Street Fee .... ................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... <I:
SETBACKS: Required
Actual
Front
Bad<
S'de
Side
BUILDING DEPAATMENTVALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2.5lfD.aD
USE OF BUILDING
----.E:. ES A 1/2..
.
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:
,4.7'5"
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I.Z.~
Sewer & Water Permit ...................... $
Gas Fireplace Permit.. ................... $
By IIding ;:I";ittIJ12:1.j"t/ 1
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
PlANS & SPECS a SETS
SURVEY a COPIES
PLOT PLAN a
Total Due .............................. $ 7~.OO
Paid ReceiplNo. .3(,4~1
Dale By .m./ i
This is to certify that the request in the above application and accompanying documenls is in accordance with the City Zoning rdinan and may proceed at~uested. 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.
Issued
CltyPlanner
Oate
Special Conditions if any
24 hour notice lor all inspections 447-9850