HomeMy WebLinkAboutBuilding Permit 99-0372
,.
I i I
CITY OF PRIOR LAKE
INSPECTION NOTICE
o/TE /
'B( ~tV
/4dH <;;; r:
-'
/: /-:;.
TIME
. SCHEDULED
ADDRESS
531~
OWNER
o~
.,r')_. ~ ""q, /
(!f;.,J...- /~
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING '-.ZLwA TER HOOKUP /l:
o INSULATION /' OS EWER HOOKUP/;;)
o FINAL 'i;;('PLUMBING FINA0/
o SITE 'NSPEC.JI."l /DMECH ~
COMMENTS: ~ h~
fAt.. so ~ Vrlt, III
/ .
o EX/GRAD/FilliNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
D~
rlLG
-1
I
J
. ,/
1i:h1c:J P 621(.
~~
I ~ ,J"
l 0 ~ w / {r.L~'11..---
'--- .-"'" I
/
"WORK SATISFACTORY, PROCEED
o CORRECT ACTIOf'I rND PROCEED
o CORRECT r:t , <rLL 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!
INSNOTI
I
I I
Q8IE.BECE'lVED CITY OF PRIOR LAKE
i f .IL BUILDING PERMIT,
4/q qCj.-' TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
y.. 2. SITE ADDRESS 1H
5 fllS- Ii/} 51)f1f I
fJ~J fJf<
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. --5-9'~ 372-
1. DATE
i-0/-99
55372 /2/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
j.flf<E M/V
PID~006- tJOh-()
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction 0 Alterations 0 , A?di~i~n E.... ~~h A_tt~C?. ....._ Re-s~g 0, Finish Basement 0
Chimney 0 Misc. ~lt..ter cr-"U CU"~ ~~~ <J~ +-e..e.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding off~n revoke this pennit for just cause. ~urthermore. I hereby agree that the city official or a designee may enter upon the property t~li':..tle~l/ !ipections.
" "\ r Signature License No. Date
3. LEGAL DESC?IPTION
LOT to _ RI nr.1{
ADDITION ~ /Jifc..~/fI1A
y 4.0W(. R/ (Name) -- (Addr~) SA '(Y1e ItS
kEVI.f/ ~EN./ M:Jv~
5. ARC T (~~dress)
1- 6. BUILDER
(Name)
(Address)
"--
x
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Tel. No.)
I-fLf6'-o37t.
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Pennit Fee ................................... !t..
City:
Plan Check Fee ............................. $
State Surcharge ............................. !t
. F;()
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennit ...................... $
~:rf&~:;~i~:.;itlr"~?fI'I
Certificate of Occupa'
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
o
SURVEY
PLOT PLAN
o COPIES
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $-L: (l~ .~
Collective Street Fee ....................... $
Sewer Tap ................................... $
s: /, $
Pressure Reducer .. 78................... $
Meter Hom .....'5/-........................... $
Water Meter ...X8.......................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
45. cJ6
/2s-.00'
/. '2 t'J (~ . c;Q
. ; 'Zt:Y1.(") (L
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $~l '.ll). SO
Paid ':::>. 1'2-0..5"0 Receipt No. _ '3JrB q 0
Date 4/ q fet'1 By ,fA t'Ji,t-
. , ....'y
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 constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Issued
City Planner
Date
24 hour notice for all inspections 447-9850
I I
Special Conditions ff any
T ....---,.