HomeMy WebLinkAboutBuilding Permit 99-1302
\-I II
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
15x3'r ~adV
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION . --r(ii) 0 SEWER HOOKUP
);i FINAL ~ /LA>.'~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
(-II
(J /1
I' ~ l-P
DATE
TIME
rH'l~
~q-13oa
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
YWORK SATISFACTORY, PROCEED
/0 'cORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
l!AU, 447-9R50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
----------_._._---~--~,.---_.__._._- ._..~- -_._--_.__._~......_---_._...._-"..,---_..__...,,-_.
'I. CITY OF PRIOR LAKE
I BUILDING PERMIT,
. - 2 . TEMPORARY CERTIFICATE OF
."/ ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
IS~'2,q
3. LEGAL DESCRIPTION
~
1. DATE
10/Z9/99
F~tn?16h<I U.
tE/5D
LOT
/
4TH
PID 25-249-- ooc,,-()
/lOON
ADDITION
BLOCK
/SLHND VIE I'll
4. OWNER
O~
j..Name)
~a.f
(Namil
(Address) (Tel. No.)
15x3Q l?1//FOA/OI ~
(Address) (Tel. No.)
5. ARCHITECT
6 B;~p 6U,JN;-MC . /33 Z5AdG:rn/"YNJ/l c.R d::J (P/t;~-
7. TYPE OF WORK FireplaceO ~o ""'2 De~e~ .5:~:h~r/
New Construction CI Alterations CI Addition CI Finish Attic CI Re-siding 0 finish Basement CI
). White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
C/9-/.3D2
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
m-~
14. FLOOR AR~PPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
SEATS
16. PROJECT COSTNALUE
~=
Chimney CI Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 Jocallaws and will proceed in accordance with submitted plans. I am aware that the
:uilding Officl~voke this p~ i7?)' Furthermore, I hereby agree that the ~i~.? O~ may enter upon the property to P:rfo/D;; Qi~9
"~S9lature, . r license No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ... .... .... ................. ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
RES /lIe
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 '74 7i:J"'
Permit Fee ................................... $
City:
Plan Check Fee ............................. or
State Surcharge ............................. <t
Penalty .......................................4:
/. 2~
Plumbing Permit fee ....................... 4:
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Areplace Permit ....................... or
Thi'~m-.Li.a.ul~ing Permit Whe, APPiiAdj
By . ~ "ll!f;tc; Date ! / z. /
I /
Certificate of upancy
17. COMPLETION DATE
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
Total Due .............................. $ 7 &,.00
Paid -; &:. () {J Receipt No. :3 &- t./ ;; ~
Data !I/Z/qq By Pd ___
This is to certify that the request In the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed alrequested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows COflstruction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447.9850