HomeMy WebLinkAboutBuilding Permit 99-1415
DATE TIME
~ 14.1:
5925 cAe.OSJ"7N o;er}
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION A
)5 FINAL .€aO;:::
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
.:To/.:,
(o",,"--ok:fu(
,
99-/.!//~
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
---------.
~
&- ~~
,;
-------
'"
~RK SATISFACTORY, PROCEED
/ ~ :~.RRECT CTION AND PROCEED
o CORREC RK, ALL FOR REINSPECTION BEFORE COVERING
Inspector:
. Owner/Contr:
447- 850 FOR THE NEXT INSPECTION 24 HOURS '''' AOI(ANC~
'lREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
. '--------.-----
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U en
DEe I 5 :999
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
tl. lltOO
1fltjtjq830"l
1. White File
2. Pink City
3 Yellow Applicant
Permit No.
99./1./15
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
5<1.1 F) rA1~~t1r~:,
3. LEGAL DESCRIPTION
/4-
('A20ItJAL
4. 9~ER (Name)
~~ W.fU.IlDIc'-f.
5. ARCHITECT (Name)
LOT
BLOCK
St. Sf:
I
'2./066
1. DATE
~ BUILDI~,~I~FORMATION
5".37" 11.SIZEOFS,nuC;,URE
()' I - i/ "^^tJ ',J . - (Height) (Width) (Depth)
Y"\OY I-(,L\<.- ~ > I!.!.!- P\ ~
12. NO. OF STORIES
(Address)
t~ SJt.SC
(Address)
PID 2.5-31(0- 0/4--0
'3 eo -ADDt\\
(Ltl ~~L:H () - ~'if>2-1
~ (n.L No.) I
13. TYPE OF CONSTRUCTION
ADDITION
f)'\2~
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
hIllY \( Sfr:qncA L1\ V\l.
7.ljPE OF WORK Fireplace 0
New Construction 0 Alterations 0
119lq Litve, \rv1I~~VIJ ~lwi. flt~M52. - 5O~t
Septic 0 De..:k 0 Re-roof~ Porch 0
Addition 0 Finish Attic 0 Re.siding 0 Finish Basement 0
SEATS
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
t 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 a entioned property and that all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
buil . g offi ial can re~Pk h;s~ 10:.il'fl cause. F~'l....,ore, I hereby agree Ihal the e;ty ome;al or ~7.e 1 p. ay enter upon the property to pertorm ~~ded ~pections.
X I "", e::? <T\1 't P/ If /; JO{113J':lQ
. Signatu-ffi LK:snse No. . Date
16. PROJECT C~STNALU.v
\..( 1'1 :>'J. (ol
I 17. COMPLETION DATE
SETBACKS: Required
Actual
-- .
FOR ADMINISTFlATIVE USE
Froot
Back
Side
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS LJ SETS
SURVEY LJ COPIES
PLOT PLAN LJ
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING _12.F.; ~ I!1/- Ie
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Divisioo 1 2 3 4
Perm;IF..................................... $ 74 75
City:
Amount Brought Forward .................. <t
Park Support Fee .... ................. ...... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... ~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
'.2.eL
$
Sewer & Water Permit ...................... $
~7ifr1:.ljiCi:.:'~fi/rl:1f1
. I
Certificate of Occupan
Issued
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ................ ......................... $
Total Due .............................. $
Paid Receipt No.
/(".O()
Date
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 as requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Belore occupancy, a Certificate of Occupancy must be issued.
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447.9850