HomeMy WebLinkAboutBuilding Permit 99-1351
HI&
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3'/:3(, ~ Sr: .5 IV
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION .. _--,fA) 0 SEWER HOOKUP
ji;l FINAL ,u ~ I \{j/ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
;-) C
Vf\
/' jJ ~ Jdi
DATE
TIME
IJ'o"9q
9 9-/05/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/}IJ(3(
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
-'"----~----- . - '--_._--_.~-.-----_.__._-_...__.__.
DATI= RI=C:EIVeJ.
11/1&/4tf. .
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.
q9-/35/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
\2. SITE AD3DRE~~3 / _
"T <0 L3I"/t...!5/lrl S T
sw
1;7t~/?1
/2../
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
/0
S uNSe;T
BLOCK
Z.
H/L.L.5
PID ~-J7?_-Ot7-n
/'fDON
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER
15. ARCHITECT
6. BUILDER
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
(Name)
(Address) (Tel. No.)
alO .?fiAlG~O.eo1 AleW
I?.-.~~+ll\" "'S-:f?,.~.'e-l/<"<:"
Fireplace 0 ~Septic 0 Deck 0 -- Re-roofin;)S Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
I"~(j(,d;
5'Ptf/ /
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
D.'II.f~lf'rJo
7. TYPE OF WORK
New Construction 0
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 in rmation 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 P~:J and th all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~ui~can rav,...js . 0 'ust cause. Furthermore. I hareby agraa t~~ /ty~~~t~aSignee may antar upon the proparty to pertli_ni1~ns7ections.
Signature - license No. Date .
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
..ok
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
- SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
j(J G:S A-I/:?..
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS Cl
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... <::
/L/9 5-0
Plan Check Fee ............................. $
I. z..~
State Surcharge ............................. II:
Penalty............................... .... .... ...
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... <t
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
a ~~~;jjj~~.i:t;nwilj;~ft1
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /..5(J. ~/5
Paid 1.t:;7). 75 Raceipt No. 3fR 5 Z.'''3
Issued . -
This is to certify that tha request in the above appl~a'on and accompanying documents is in acemdance with the c~:;on:,:~~~~~ may pr~d l'!.;;:,. 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.
CrtyPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850