HomeMy WebLinkAboutBuilding Permit 99-1317
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCH~DULED
,
ADDRESS
Lf//o fJfl-.-wI .9.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULAT~ON r21
FINAL I(!/
~ SITE INSPEC ION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
.~ ~ rJ./lA4
t)/i
ck1p
DATE TIME
/ckJ.-'t'\
'1'1-/3/7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
'j!{.e...r p
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
I?\A
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IlVS/VOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
QATI= !:::n::r.FIVl=n
/1/e/9?'
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. CJ9 -/3/7
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
I.J./ID fU4J.SAu-r 5-r S~
1. DATE
.-elSe;
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTI,oN
LOT /1) i I ( BLOCK 2
ADDITION L /JK[;J'/OF 6>~'7J5,
14. OWNER (Name) (Address)
PIl'"T P~III""'- '-1110 f'11i.ASAAJ"- S-r 5 L-
15. ARCHITECT
6. BUILDER
12. NO. OF STORIES
PID
2.<:'--06&, - D/Y-O
13. TYPE OF CONSTRUCTION
(Name)
(Address)
(Tel. No.)
LNl-2SLN
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
fl,
JLt>JD Srl:;.AAlc I ~ L..,
Deck LJ Re.rOOfing~ Porch 0
Finish Attic 0 Ae-siding 0 Finish Basement CJ
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~ ~1Uu)bllS
7. TYPE OF WORK
Fireplace 0
Alterations (]
Ca f<;;-T
Septic 0
Addition 0
L/'f7-/~?L
OCCUPANT~
New Construction 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. 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
bUildingw ~~k this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfonTl needed inspections.
X 1-.> 11-8-'7'''1
Signature License No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.R'F3 4j'"e..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
ZJOC.C/Z/
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H r M R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... q:
7</7
-
I
Plan Check Fee ............................. It
State Surcharge ............................. <t
Penalty ....................................... <t
I. z..r-
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ... ................. .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... It
Sewer & Water Permit ...................... <t
. n.Bermnm......../l...I..rJ..;,'~I.n.9..~..:.';'I.tWhn~/n""~..J,~c, Water Tap ................................... $
~Jlj!JeYr' Ii I") I'7 / Builder's Deposit ............................ $
Other ......................................... $
Certnicate 01 Occ~an' I Paid T;~; ..Jii..........~~~~i~;~O$ 3~ ~~?i()
Issued . . 1
Dat. ///Y/99 BY,~
This is to certify that the request in the above application and accompanying documents is in accordance with the City ZoningUrdinance and may proceed asJ&quested. 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.
C~yPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850