HomeMy WebLinkAboutBuilding Permit 99-1339
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION IAl 0 SEWER HOOKUP
X FINAL AI ~ ICY 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
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DATE TIME
cr7-/339
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASllNE AIR TST
o
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAll 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 & SAFETYl
INS/'fOTJ
-----_..._...,._"------_.__......_----~.-
DATE RECEIVFD
II //(p /91
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. <'}9- [{ :;;q
,-
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
2. SITE ADDRESS
/5906 ,c/2EMDN'T /I VE NW
3. LEGAL DESCRIPTION
1. DATE
/I-jp -9r
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
RISD
12. NO. OF STORIES
2S-ZLf9-n<,!.o-nl
I
I
_5
4TH
3
LOT
BLOCK
15L/I/VD I//;-";W
PID
13. TYPE OF CONSTRUCTION
ADDITION
4.0WNE~4am~ V.e~ '
5. ARCHITECT (Name)
(Address)
.:S'"
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
e....
(Address)
(Tel. No.)
6. BUILDER (Name)
OlA~fr~ ~
(Address) . -4. ..,,(Tel. No.) ~
1-c/1 ?i"Y/b/S1f<>r=0 ~':JI
~'~(..e. ~ L~ tl(1I 5"fj' ~
Deck ~ Re.rool'~ Porch ~
Finish Attic 0 Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Fireplace LI
Alterations 0
SepticLl
Addition 0
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 info n do 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
roperty and that construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
evo this pennit f r j~SI use. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
<.- _ . -c.e.I';!('< - .'7'.;2.. ~ '}> //-~-9;/
Signature License No. .."~
17. COMPLETION DATE
x
I
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LI
PILING LOGS " PERCOLATION TESTS "
Back
Side
Side
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
/ilK'
.eES
USE OF BUILDING
PLOT PLAN
"
TYPE OF CONSTRUCTION: I It III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty............................... .... .... $
Plumbing Permit Fee ....................... $
Mechanical Pennit Fee ..................... $
V
R S U
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
/L/q 50
Jtv
~<V .;(
() 1"v
, .,\.,It
'-~
/ 2~':)
Pressure Reducer .......................... It
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... ~
Total Due .............................. L...L.5-Q.7.">"
Paid /'0-0. 1~ Recelp\tiO. =?~, ,Ic/
Issued ., .. /
Date f(/I&/C(LI By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoninglordinaAce and fnay proceed4S requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificare-~f Occupancy must be issued.
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By~lt-~ I Date /~
f
Certificateo!
City Planner
Date
Special Conditions if any
24 hour notice for aU inspections 447-9850