HomeMy WebLinkAboutBuilding Permit 99-1290
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
SCHEDULED
~'\
DATE
rIME
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.571'1 <;~~ ~
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-~ ,-_~tI ~ 01(
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION /,;J
Ilf FINAL A.(Jfr( \tL/
o SITE INSPECTldN
COMMENTS:
.(2) ~ 76,
......' .~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
-
d~ I-~
79- 10<70
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLINE AIR TST
o
-
*ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ ,Ir~ Owner/Contr: _
CALL 447-9850 FQR THE NEXT INSPECTION 74 HOURS IN ADVANCE
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT}
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CITY OF PRIOR LAKE .,
BUILDING PERMIT,
TEMPORARY CERTIFICATE 0
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 9f- /z- 9 t)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
to-,-,<-c,q
BUILDING INFORMATION
", SIZE OF STRUCTURE
(Height) (Width) (Depth)
2, SITE ADDRESS c70. J
oJ '"' ~AIII"'lIhf\
1te...:/
3. LEGAL DESCRIPTION
7
12. NO. OF STORIES
LOT
BLOCK
PID 7.5- 171 - 007-0
4 OWNE1; rl,J
5. ARCHITECT
~ame)
t(IY!J//ljg",
(Name)
I
:PR'.W 1!- 1ft 0L.-
(Address) ./
J:;7ql-j 5At>,~I1l'/" 7/A:I
(Address)
(Tel. No.)
t/1{7-15i7
(Tel. No.)
13. TYPE OF CO}jSTRUCTION
,,~ro-ttfI
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Address)
I~""""n
Af\1'H"t:b<{I~k:IrJ:~~ rb..it'bo."ltx~ jV.'CQIH h f.
Fwplace C1 Septic C1 Deck C1
Alterations 0 Addition C1 Finish Attic C1
(Name)
(Tel. No.)
7tn--Bj S^~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT>:
New Construction 0
Re.roofin~ Porch C1
Re-siding C1 Finish Basement C1
SEATC:::
7. TYPE OF WORK
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. 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 authorized agent for
the above mentioned property and that 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~? can rey~this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X r--ff'/ ....OI.6Q....~ /.c;--z..<r--(j4
Signature Ucense No. Dale I
16J'IjPJECT COSTNALUE
, !>,Ooo-
17. CUMPLETION DATE
FOR ADMINISTRATIVE USE
- SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
C1 ENERGY DATA
o
pJ:iS nf~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS C1
SURVEY 0
SETS
COPIES
c.sO/) JU
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee .... ................. ...... $
SAC ..............,.......................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
7<J.1{"
Plan Check Fee ............................. $
(.'1-5
State Surcharge ............................. $
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Penalty ....................................... <t.
Plumbing Permit Fee ....................... It
Mechanical Permit Fee ............. ........ $
This
By
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid ib.c:;q Rece~Pt '>
Issued
Date ID!1j!<it1 By ./
ThiS IS to certify that the request In the above application and accompanying documents IS In accordance With the City ZOning drdlOanle and fnay proceed requested. ThIS document when
SlQned by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be Issued.
ou' E!u;ldlng Penni! WJ1e1 APpr11t~
Date /0 ?_P'i
7G..oO
3/,,<!-7/
CRy Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850
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