HomeMy WebLinkAboutBuilding permit #99-1305
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULeD
ADDRESS
5333 ~ f:;,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION . ..//.ii1A
11 FINAL ^" ~;:::rfA!Y
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
-
~1
/Jh, fJO
0-13
jJ..-61'f
DATE
TIME
'lJ- /30S
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~OWner/Contr:
I
Inspector:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
---"_._._-------,--~.-
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CITY OF PRIOR LAKE
BUILDING PERMIT,
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.SITEADDRESS~ J . /1' A
5333 ~~.
;;73/17'
..el
3. LEGAL DESCRIPTION
LOT "')
PID ZS -I %7 - ()(f;:-O
"XPrJnr'.\v/u..f: /11(j.\ r,.-,-rrr
4. OWNER ~el /1"ddJ"SS). /I. '.1.
~.~ 5'333 /~ (.A..MU.L
5. ARCHITECT
BLOCK
I
ADDITION
(Name)
(Address)
(Tel. No.)
,/1f7../'}()(J/
(Tel. No.)
~e)thdtj3f(,~;4~p
(Tel. No.)
1/fS:-?f?/
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
DeckCl
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- /.~()~
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
{Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
::'~3~1sUE
''1!71tJ /9A1
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULV~H I ::;ILI::.
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 d 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
:Uil in icial can (evoke t. e it tor just us.e~ore, I hereby agree r.:!tti//}:';cial or a ~t nee may enter upon the property to P~/...3/ 9SjiOns.
License No. ~ Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Side
Front
Baok
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
IZES !"tIff
PERMIT VALUATION
-z <:"lYV. /. U
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
-;<-1-1\
Plan Check Fee ............................. If;
State Surcharge ............................. If;
/.L\
Pressure Reducer .......................... <1'.
Penalty ....................................... <t
Plumbing Pennit Fee ....................... If;
MATERIAL FILED WITH APPLICA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 70 -cJ U
Paid I Ie .o-V Receipt No..3''' <I B b
Date /1 hlli'i By./kh'C
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proc~- requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificaf( of Occupancy must be issued.
Mechanical Permit Fee ..................... If;
Sewer & WaterPennlt ...................... <t
Issued
24 hour notice for all inspections 447.9850
Special Conditions d any
CilyPlanner
Date