HomeMy WebLinkAboutBuilding Permit 99-0338
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CITY OF PRIOR LAKE J. _ L
INSPECTION NOTICE SCHEDULED eYfo/11 z. :30
ADDRESS :5355 J 40 7H sr.
OWNER CONTR. Sf&.<} rf/:.ii-977
PHONE NO. PERMIT Nc?P. 78
o FOOTING 0 PLUMBING '. rt""~~,(JG~/FILLlNG
o FOUNDATION 0 MECH RI 0 COM~NT
o FRAMING 0 WATER HOOKUP U I-II'(I:PLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 PLUMBINGFINAL~ 0 G~~AIRTST ,y./
o SITE INSPECTION 0 MECH FINAL ~ '!< (/t1otf=. dr' "r
COM~ENTS: / II "fr. hJ(" ~ fflA-/ ~ ~ r I
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
. 0 CORRECT W~R~~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ { Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNQTI
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QATE R~EIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MIl t 8.
1. DATE
'-1/1~/9 if /1.
2. SITE ADDRESS /<...1
S355" -1'fofL, sr 1-lE 1 Pll/ol! LA/<i;J 11/J. SS 37~
3. LEGAL DESCRIPTION
LOT .s- BLOCK PID~ -0 t:d:J -{)OS-. ()
ADDITION }J 02;:(JJ SHO 1l.IE. OA KS 8 fLST Brlill,., 0'"
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4. OWNER. (Narn.e"-~~ J ~Address) p~ tllfJ:: ~ (Tel. No.) '1'(1<>-
K~ -J ...~.s~/E-'-hJ 63SS.-/~ sr~ ;J.S-a'O
5. ARCHITECT (Name) (Address) (Tel. No.)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 '\ Additi010. FinisHttic 0
Chimney 0 Misc. ~ll ll~ ~ tfSZ...
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
Sq. Ft. Width Depth
Re.roofing 0 Porch 0
Re-siding 0 Finish Basement 0
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq -33 <?
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
I 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 above mentioned pro 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
bUi~~an re e this ermit~se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
~p~ . /'. "/ .A'
// ./ Sign.!ture t1 -' License No. Date
Amount Brought Forward .................. $
Park Support Fee .... ,...................... $
SAC ..............,.......................... $
Collective Street Fee ....................... $
Sewer Tap ...,....,...................,...... $
~~ } $
Pressure Reducer ..... 'b.................. $
Meter Horn ..'r;l'r'......................... $
Water Meter ~............................ $ I 2S. 06
Sewer & Water Connection I-!le ........... $~CJC) L6>6.
WaterTowerFee ........................... $ 7~ t'I
Water Tap ............,...................... $
Builder's Deposit ..........................., $
Other .........................'............... $
Total Due .............................. $ () \"df) - ~
Paid 3\ db. _ SO Receipt N;~'SW.b\
I Date L\ -13 .1{L( By (\..~.Lt.J
s to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as request:~ This document when
Kf by the City Planner constitutes a temporaty Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
IUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
SE OF BUILDINl2a.o. J4 /IL
t
~.,.
YPE OF CONSTRUCTION: I II III IV
Iccupancy Group A B E F AI M S U
Division 1 e..J>
3rmit Fee ................................... $
PERMIT VALUATION
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City:
an Check Fee ............................. $
Ite Surcharge ............................. $
.5n
laity ....................................... $
'llbing Permit Fee ......................, $
:hanical Permit Fee ..................... $
Perm~ ...................... $
*~;:,~;i:t~~~~
city Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850
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MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
o COPIES
PLOT PLAN 0
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I f'l <;' ('). l) 0
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