HomeMy WebLinkAboutBuilding Permit 99-1342
DATE TIME
CITY OF PRIOR LAKE I d-~6~r1
INSPECTION NOTICE SCHEDULED
,
ADDRESS '1070 /s9d Sr- Al..h!.
OWNER CONTR.
PHONE NO. PERMIT NO. ?9-/3lj;J.
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION ~@ o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL ^'" o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: CJ/'
/1
/' &0 {--db
~ORK 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 & SAFETYI
INSNOTl
0' PR/OIi' I r2 Q,-,rn,rfillVr<6' r.:;> -:.
C\,~( I~D l5 !'e;',IO. ~rw 15l' CITY OF PRIOR LAKE
Ii ~ '"?;;:I.II --~'=:-_~-'-:-llji. BUILDING PERMIT,
. \~ NOV I 6 ~ 1\ EMPORARY CERTIFICATE OF
! I : ZONING COMPLIANCE
I . . . . 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)
" D;") III } \ ~
PcJSD
2. SITE ADDREf,j'iO
I~ 'iT'-.. St. AJ. 'W .
3. LEGAL DESCRIPTION
--;
BLOCK 2-
tYINO.sONG
PID 2..5-23"'- 6/0-0
/) 11/ 7716 L../J K-b
1\ (Tel. No.)
1<:;'1 ,<;tAJ.llJ. ~ll-'l'Iu-7iV(
(Tel. 'No.) I
LOT
ADDITION
4. OWNER (Name)
~~" (~~ \.. .~ r-u
5. ARCHITECT- (Name) - - ~
(Address)
Lj~
(Address)
8.BUn.DER (Name) (Address) (Tel. No.)
\ ) A "-.)9 9.. .J..' .A.^-..)Q. L~\S Aj
7. TYPE ci-\YORk "\ Fireplace 0 Septic 0 Deck 0 Re-roofing:il" Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement CI
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. -!l9-- ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Haight) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. 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 th t nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revo.\8 this pe~t . sl e. Furthermore, I hereby agree that the city official or a design.ae may enter upon the property to p~. rf .. .. lnspections.
X ~ U" . ~,""){""' . t. ~
~r ~ ~No. ~j
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... <1:
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ... .... ...... ...................... $
Water Meter ................................. CI::
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... ~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
?5V 0_00
USE OF BUILDING
E. F..... "5 AI / R....
1
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 ................................... $
74.7S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ..... .... .... $
Plumbing Pennit Fee ....................... $
J.2..}
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Water Tap ...................................0;:
This Builder's Deposit ............................ 0;:
By Other ......................................... $
Total Due .............................. $~7 (4-00
Pa,d 7(1- 0 0 Rece,pl1lIo 3(P5!fo
Issued Date II It,.. /Ctq BY~
ThiS IS to certify that the request In the above application and accompanYing documents IS In accordance With the CIty ZOnln' ~rtay procee s requested ThiS document when
signed by the City Planner constitUtes a temporary Certificate of ZOning compliance and allows construction to commence Before occupancy, a Certiflca e of Occupancy must be ISSUed.
C~yPlanner
Date
Special Condilioos ~ any
24 hour notice for all inspections 447.9850