HomeMy WebLinkAboutBuilding Permit 99-1393
ADDRESS
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CONTR.
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PERMIT NO. 9t?-13'13
o PLUMBING RI o EX/GRAD/FILLING
o MECH RI o COMPLAINT
o WATER HOOKUP o FIREPLACE RI
o SEWER HOOKUP o FIREPLACE FINAL
o PLUMBING FINAL o GAS LINE AIR TST
o MECH FINAL 0
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
?!-FINAL Jt:i'O~
o SITE INSPECTION
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COMMENTS:
Wi
/M ?i
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)(l" WORK SATISFACTORY. PROCEED
Lb CORRECT ACTION ANO PROCEEO
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:
CALL 447_9860f9R. THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4< SAFETY!
("t'ff..... Owner/Conlr:
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'/~TizJ'rJ
1. White
2. Pink
3. Yellow
File
City
Appticanl
Permit No.
qq-/2H3
- DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
~.EfR~ PytMlT IS ISSUED (Please Print or Type and sign at bottom)
~~1( 5fItN"-./
3. LEGAL DESCRIPTION
9-;
P/210,e .,-
LOT
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H / U...__
f.ZJSD
<.
BUILDIN.RMATION
". SIZE OF STRuetURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
BLOCK
PID
2-!5-l7q- O{")B-()
ADDITION
f$VNER a~N~";;~w &e;~"ZSh~~ (Tel No.)
15. ARCHITECT (Name) (Address) (Tel. No.)
Eb. ;iJl"(f:;f'..J..~~~~ k::li(:~
New Construction CJ Alterations LI Addition LI Finish Attic LI Re.siding LI Finish Basement LI
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Fl. Width Depth Yes No
I hereby certify that I have fumished infonnation n 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 that all co ruction 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 rev~js pefPfl'it for j ause. F~rthermore, I hereby agree that the city official or a designee may enter upon the property to p~rformt%. . d_ inspections.
~l( -'/ --- - ~ ,,,.,,.,-9,
/ SignaturV License No. . Dale
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS 0 PERCOLATION TESTS LI
PLANS & SPECS LI SETS
SURVEY LI COPIES
PLOT PLAN LI
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
R.ES q/Je_
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
;;> S-OO. ur..J
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Ci1yo
Amount Brought Forward .................. ot
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Division 1 2 3 4
Permit Fee ................................... $
7<-1-.7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
1.7-~
Mechanical Pennit Fee ............. ........ $
Pressure Reducer .......................... $
Meter Hom ........................ .... ....... It
Water Meter ................................. It
Sewer & Water Connection Fee ........... It.
Water Tower Fee ........................... It.
Sewer & WaterPennit ...................... $
:: F~~l:nn~frlt m.~... ......;I~'~~.~.e:" When ftr~ /
By 'f::f;ft:-~ 1n /' _ Date I? J l-c
! I
Certificate of Occupan
Water Tap ................................... It.
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ "7 (p. 0 0
Pa,d tro 0 0 Rece~Pt q 3(,,6&&
Issued . v) /i /JA
Date /2-/<.../"11 By ~
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 requested 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.
C~yPlanner
Date
Special Conditions if any
24 hour notice for aU inspections 447-9850