HomeMy WebLinkAboutBuilding Permit 99-1330
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ADDRESS Il.JZ\..O
,,""'.,... 1117 qf
~75h~ 4v~
It;""Ou
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq- , 330
o FOOTING
o FOUNDATION
o FRAMING Pr
P .JNSULA TlON
Jjt"FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMME
'\
P)-4M'~,
~f&. )
--
')( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'7k
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl
.......-...-....-.-.--.---------.-..... --.--.-.-......-.,--. .." ~-~.~-,_..-_._-_._.__.-
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-/33Q
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITE,Z1r 0 ::r;~-M
I-u e.--
1. DATE
/I //2 f=j'7
j I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
s
BLOCK
2-
s/m..er
PID
0/7 r S'
25 -of14.-- 0/3 -d
?1m
13. TYPE OF CONSTRUCTION
/i/CJK'771
4.0WNER~Name) :;;ehtP1~
ADDITION
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT (Name) (Address) (Tel. No.) I
I
6'7ER / ?am, e) 73or1'.e;.~~., C?13/';;f~f1'?:l""J 15. NUMBER OF OCCUPANTS OR SEATS
~~t? ~ ~~ ~ ~ OCCUPANT~
7.TYPEOF~RK 17~'ePlaceo Sepllco ~:r ~{.s,:rfte:orChO SEATS
New Construction 0 Alterations 0 AdditIon 0 Finish AttiC 0 Ae-sldlng CJ ' Rhlsh Basement 0 16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
I hereby certify that I
the above menti
building
X
r: CULVERT SIZE
Yes No
ich is 10 Ihe besl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
to all existing state and Jocallaws and will proceed in accordance with submitted plans. I am aware that the
ereoy agree that the city offic;al or a designee may enter upon the property 10 perto~ i~'
License No. 'Oat 1
17. COMPLETION DATE
Signature
Front
FOR ADMINISTRATIVE USE
MATERIAL FILEO WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT V ALUA TION 2'Ou. ,,~ PLOT PLAN 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PES. /-'1/ #'
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. or
Park Support Fee ........................... II:
SAC ......................................... $
Collective Street Fee ............. .... ...... $
Sewer Tap ................................... $
.
Division 1 2 3 4
Permit Fee ................................... $
"/'-1 'I r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ..... .................................. $
Plumbing Permit Fee ....................... $
I.":? \
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... It
Meter Horn ................................... $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
~:ts. Flr;:l~if:~~.tAL~:,~i~~.~.e:~ ih1!~~v-~(l
By. PJ7~ __.15, ';1rf Date I / 'l
. (Ij" I
Certificate of Occupancy'
Water Tap ................................... It
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. . --I (c. () ()
Paid 'l'C-, 0 0 Receipt No, .3" --;07
I~~ I
Date /I1/7IC;C) By -IftL_
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'S request~. 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.
CRy Planner
Date
Special Conditions it any
24 hour notice for aU inspections 447+9850