HomeMy WebLinkAboutBuilding Permit 99-1361
CITY Of PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS /c50.~) {y S-O{! -O{"
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
R 0Ci-J:::'
COMMENTS:
~~
DATE TIME
/ (r d- t.f-(I/
iIo"~/ pi-
~
qC;-/3.C:.- /
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WIlK' CALL FOR REINSPECTJON BEFORE COVERING
Inspector: 1i1>j I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
''''SNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
fl ~ 0'< PR/O..;>
!;~"
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Plint or Type and sign at bottom)
2, SITE ADDRESS
~5D:;).
3. LEGAL DESCRIPTION"
/, 50 tf -6- {; ::i'~
~ \.,
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lk ~i!~_~E::'VE.D, _., CITY OF PRIOR LAKE
"U' - -- --,,:. BUILDING PERMIT,
P NOV I 6 IB J]f' MPORARY CERTIFICATE OF
': ZONING COMPLIANCE
~TILlTY CONNECTION PERMIT
I /'7~ J3'-j9',//~INGINFORMATION
)' l I O. - J::/ 11, SIZE OF STRUCTURE
'7<1 r PDr Jg,>--r:-eCG:' (He'ghtl (Wldth) (0....1
P\J5D' 12. NO, OF STORIES
PID 25- 2-40 -n(2--0 -:2...
'WPE OF CONSTRLJRION
j\ -eo.... rc>o~it::l9
14. FLOOR AREA APPORT10I\IMPNT USE
I White
2. Pink
3. Yellow
File
\~JY
Applicant
Permit No.
99-/30/
/2-
HA12Rrl~
4.0'l'>fER /. (Name) / .
I7QrPor Vi e w
5. ARCHITECT (Name)
lOT
BLOCK
~ (Address)
LOm/Y) ,
(Address)
AODrJ
/ / (Tel. No.)
NSx-.o, 1/9,6-'72'6:;;;
ADDIllON
f=)nt
(Tel. No.)
/I;2C/LC(Namel 11 5'83 ~?f 0" ~.~o5 -OD;lD
<<DC)~"()C. ec/'('-"'<)vl>/I~,!l1/f) 553?2
:~ SEAT~
7. TYPE OF WORK rJ Fireplace 0 Septic 0 I Deck 0 Re.rooiin9"l=\ Porch 0
NewConstructlonLJ AtterationsO Addition 0 Finish Anic 0 Re-sidingo Finish Basement 0 16.P. '"1AOJ?STCOS;I)'~Uj/E J /
Chimney 0 Misc. ex.... /) 97" a/ ~
L ....
a. PROPERTY AREA OR ACAES _ ..-J 9. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPL:ETION DATE -
Sq Fl <f?1? 0 D 5f1Width Depth Yes No 1,;( -/5' -;; ;;
I hereby certify that I have furnished information on this application which is 10 the best 01 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 submined plans. I am aware that the
:Uilding o'(Xj~ehQ:Wrmi~~r~se. Furthermore, 1 hereby agr~;;;iCi~~ali~~nee may enter upon the property to pei7 ~i3~99'
itgnalure 0 ~ . License No. Dale
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
FOR ADMINISTRATIVE USE
Front
e...
Side
Side
MATERIAL FILED WITH APPLICA nON
SOil TESTS 0 ENERGV DATA 0
PILING LOGS C] PERCOLATION TESTS a
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12.-65 Ale.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS LI
SURVEY a
SETS
COPIES
2-::> () c), au
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
V
R S U
City:
AmounlBroughl Forward .................. $
Park Support Fee ........................... $
SAC u...............u.uumu............ $
Collective Street Fee ....................... $
Sewer Tap ................................... $
14,"75"
I.?~
$
Pressure Reducer .......................... $
Meter Hom ................ ................... $
Water Meter ................................. $
Sewer & WalerConnection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Penalty ....................................... (:
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... <t
Sewer & Water Permit ...................... <t
ThiS
By
Other ......................................... $
TolalDue ....u.uuuu.m........... $ 7,.. II 0
P.,d /4>.0 () Rece'p~o 3,., S'3 e
Issued I I
Date 111'11'1 By
ThiS IS to certify that the request In the above application and accompanYing documents IS tn accordance Wlthlhe City ZOOlng Ordinance and may proceed a uested. ThIS cIocumenl when
signed by the City Planner conslitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy musl be issued.
City Planner
Date
Special Conditioos if any
24 hour notice lor all inspections 447-9850