HomeMy WebLinkAboutBuilding Permit 99-1293
ADDRESS
'-~ S; g';i
DATE TIME
SCHEDULED !to'-~-( _~~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
71- / ~ 9-3
o FOOTING 0 PLUMBING RI
o FOUNDATION@ 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
MINAL 0 PLUMBING FINAL
-=~;::~"Kooi'iSd/~
f ~
(if /"ra..R ~ fl .
o EX/GRAD/FilliNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
",
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ALL 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
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I i6FuJ q9
~nsS0.J()nA Cif'r W, Sw
.3
WIt.LOIAJS 3/€-O
4, OWNER (Name) \ ~ (Address) (TeL No) '1''-1.1- I-\CAI
r(',(N Ilu~ ffil\ft'\6iCf 3s~ ~?'5u)cxx\.('.if.~IL>
5. ARCHITECT (Name) (Address) (Tel. No.)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDRESS Ll
?'S'o.:z
IZf
3. LEGAL DESCRIPTION
3
BLOCK
PID 2-5-/10-0/5-0
LOT
ADDITION
('l (Ad'MSS}-, _. I (Tet No,)
\;;}D3'S .v\i* ~C-- lDi-
~)r~Il\\.(>.m\\S~I_ .\.OIl;D
Fireplace a Septic a Deck a Re-roofinr\ Porch a
Alterations a Addition a Finish Anic 0 Re.sidi Fmish Basement 0
6. BU~~E_R_ " -. (Name)
f\~'~
~~j I\'C.
7. TYPE OF WORK
New Construction 0
"* :203/
I. White
2. Pink
3. Yellow
r.:;./0"'CL
File
City
Applicant
Permit No.
91-/2-93
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Heignt) (Width) (Depth)
12. NO. OF STORIES ;;(
13, TYAE OF CONSTRUC~N
n . P N",* + .I'd W1J
14. FLOOR AREA APPORTIONMENT U~~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJECT COSTNALUE
If J~{M I CO
t7, cCJMPL ION DATE
11- J~-qq
Chimney a 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
buildin 'cial can rev e this p'ermit for jus cause. Furthermore, I hereby agree that the city official or a design.aa may enter upon the property to perform na~ed in~P7ctio~
X j blJJI ~g/0-::"'eNO 1{')I'?t?iq~
FOR ADMINISTRATIVE USE
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 ................................... $
SETBACKS: Required
Actual
Side
Side
Front
B.d<
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
..c::,{f1) .UJ
USE OF BUILDING
,eo n/IC--
TYPE OF CONSTRUCTION' I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4 7t/ /S
Permit Fee ................................... <I:
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ...................... ......... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.2.-5
Sewer & Water Permit ...................... $
:~: Flre~la? r~" ~~Jjjji.~;,~i~~.~e~1I When fjProvfit /
By ~) 7g:r Date / 0 ~e;
/ \ / I
Certificate of OccupafJcy
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Builder's Deposit ............................ !t
Other ......................................... ~
Total Due umuuumuUU'UUU'U $ --:1'" .00
Pe;d -; (d) V Receipt No, .;3(04 '7 ?
Issued i ~
Date /11 2-bj'1 '1 By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdinance and may proceed requested. 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.
24 hour notice for all inspections 447-9850
Special Condilioos ff any
C~y Planner
Date