HomeMy WebLinkAboutBuilding Permit 99-1406
CITY OF PR!OR LAKE
INSPECTION NOTICE
ADDRESS ~('~:1
OWNER _ =
PHONE NO.
DA. re TIMe
SCHEDULED /2 - I-) A. _ f. ~
N~~i-
o FOOTING
o FOUNOA TION
o FRAMING
o INSULATI~
~AL OOF
o SITE INSP ON
COMMENTS:
-
~
~
CONTR.
PERMIT NO.
99-/<f06
o PLUMBING RI
o MECH RI
o WATER HOOKUp
o SEWER HOOKUp
o PLUMBING FINAL
o MECH FINAL
o EXtGRAD/FILL/NG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASL/NE AIR TST
0_
-
-
-
11 WORK SA TISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wo . CALL FOR RE/NSPECTION BEFORE COVERING
\
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YoUR PERSONAl HEAlTH & SAFETY!
Inspector:
OWner/Contr:
lN8N0Tl
~\
,Q:;:;:;79~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
;:tf 5") <6 I
_I
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2 SITE ADDRESS 'i/~ A~Vl50nr ~1. s;..E.
1. DATE
1'L-7-11
;e ZSD
3. LEGAL DESCRIPTlON
q
I
PID LC:;-IB3-0()"f-O
BLOCK
LOT
ADDITION
(Address)
1t'/~ f'~"'A...+~f,
(Tel. No.)
't'tLJ-J3rr
(Tel. No.)
(Address)
6. BUILDER
(Name)
(Address)
/'l.....'17
Ave
(Tel. No.)
707-6 9.>~
;11.' cdM
5.
A ,,~r" ell<" /f'...:/J, ...." (vd-rr-,Jorr
7. TYPE OF WORK Fire~ce 0 Septic 0
New Construction 0 Alterations 0 Addition 0
Deck 0
Finish Attic 0
Re.roofin~ Porch [j
Re-siding 0 Finish Basement 0
I. White
2. Pink
3. Yellow
Permit No.
QQ..-/4f}6
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CRNSTRUCTION
r ~rt~#
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. P':lPJECT COSTNALUE
/ J/. 8-tJI? ~
17. COM{LETION DATE
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" ,;"" ..",,,,,., 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 that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building o~~can r~v; this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
., ~___.4:T -t..P~"'~1. 1L.-9.~
Signature license No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... ~
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................ .... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ -?t..c/U
Paid 7C1~f7Z-. RecaiptN . ,J't,S7"f
Issued / -
Date 1'1.jt 0, 'fc.y By
This is to certify that the request in the above a~lication and accompanying documents is in accordance with the City Zoning Ordinance and may proceed a 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.
SETBACKS: Required
Actual
Side
Side
Front
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
25V1> . d'lJ
USE OF BUILDING
Jet:: {' R iK...,
>
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
O",,~o 1 234 7J..70;-
Permit Fee ................................... $
Plan Check Fee ............................. $
City:
State Surcharge ............................. $
(.'l-\
Penalty ....................................... $
Plumbing Permit Fee ....................... :t
Mechanical Permit Fee ..................... ,'I:
Sewer & Water Permit ...................... $
This
By
rmlt. ...... ............. $
"ding Penn" iz:/t~rrJ,,'}I)e:,
Date 111"
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
24 hour notice for all inspections 447.9850
Special Conditions it any
City Planner
0."