HomeMy WebLinkAboutBuilding Permit 99-0098
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
ADDRESS
,~ ~t!3
/tJ~~9-0-3
Vv
OWNER
~NT~
PHONE NO,
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
fX FINAL
\,/' 0 ))ITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
ot?- {}t19Y
I ,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: .0 b~ Owner/Contr:
CALL--X::FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
_ DATE RECEIVED
1-"-:--
F'\lJ::.lU Ae -/317
File
Ocy
AppUc:ut
CITY OF PRIOR LAKE
ol BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
18 ZONING COMPLIANCE 'T11I~ p~ rr 14 f~..... ALL Oc..!
II_NO UTILITY CONNECTION PERMIT Permit No. ~9'" CV18
UN I TS ON b\."(;.. \.O~- ~
~ ~1~FJ(Jlt.oN I
11. SIZE OF STRUCTURE
(Height) (WIdth)
/.._~
\.
oECTlONS
- ~PACES NUMBERED 1 THRUo.17.MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
ll.{(,,/- JS'~I S..y kM ~L.L'S
3. LEGAL DESCRIPTION
LOT ~ BLOCK
ADDITION 0'/ lfl1 t ua.fef/
1. DATE
~.w .----, ----;-..--.----...--. ....
D,It. ;! 1"&f1.{']I_jl(l>-? ?J.."('N ....,.rU;t..
( .
~ II;), !qq
- ..-.~ 17 /1 <:: ()
rP. .. N to<> .. I\.~ ,....)
PID dS -350 -a:)(.., ../
I
/~ hfdJ1,
4. OWNER
(Tel. No.)
(Name)
(Address)
5. ARCHITECT
(Tel. No.)
(Name)
(Address)
6. BUILDER (Name)
r:'1 fti'-(;.q;Hl.b Fp"\I#.~..~(L
~GRVlce X,..C.
(
7. TYPE OF WORK
New construction)(,
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES
Sq.FI.
(Address) , (Tel. No.)
J.().F~- Vf,,"re 6J!'4(O. AI/F. tt." '?u,rS c...
JVA-r/..~~o1> M~, s.n t!7" tr/-?<{~-9Y'?
I
Fireplace CJ Sepllc CJ Deck CJ
Alterations CJ Addition 0 Finish Attic 0
Re-roofing 0 Porch 0
Re.sldlng 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes
No
I. White
2. Pink
3. Yellow
.Ji
';11
:'
(Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FlOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
~6, PROJECT COSTNALUE
ofT"3[) O&CJ~
~
17. COMPLETION DATE
I hereby certify that I have lumlshed Inlonnation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authortzed agent for
the above mentioned property and that all construction win confonn to all existing state and local laws and will proceed In accordance with submitted plans. I am aware that the
bui~in.g ofJiplal c;r revoke this pennit for just cause. Furthennore. I hereby agree that the city official or a designee may enter upon the property to perfonn needed Inspections.
~~~ ~ .e(!)OO/13 /-)..(.-1'7
.~//S;,~lute , UcenseNo. Dele
Amount Brought Forward ....,......,...... $
Pari< Support Fee ........................... $
SAC .....,..,....................,....,...... $
Collective Street Fee ............,......,.., $
Sewer Tap ......,....,......,......,......... $
$
Pressure Reducer .........,..........'..,.. $
Meter Hom ..,..,....,................,..,.... $
Water Meter .....................,......,.... $
Sewer & Water Connection Fee ..,....,..,$
Water Tower Fee ..................,..'..... $
t;;1~ecom'~'''' '..'..':ld..I.'n.g..;'a'etnnSe lOt ~th~~,:::,v1T W.", T" ....................................
A _ Builder's Deposit ..,........,..,..,.......... $
Other.. ....,..,.... .................... ..,.... $
1 . CM 'Li1-
111flcateofOccupancy Pakj TO~~~~'~..3'C(..'....~:~I~;~0~ ~ C(--r ~~r\
Issued . ~. :
~ Date ,~-3.1{c/{ By (J~.
this Is to certify that the request In the above application and accompanying documents Is In accordance with the City Zoning OfdInance and may proceed as ~ed. ThIs document when
signed by the City Planner constitutes a t"".....".../Y Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of OcaJpancy must be Issued.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
FfOnl
Side
Side
Beck
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF B>{ILDING '.
V~, JJ- /R
/
PERMIT VALUATION
"'50" C)C) () . CZ)
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A BE(:$> I M 'R-" S U
Pennit Fee .........,~~:~~~...1....,..,..~,.. $ '3 ie{. 7 S-
"2. 5{... . ~L
I~ .dO
City:
Plan Check Fee .............,..............' $
,\ \J~
V~~~
\
State Surcharge ......,..........,........... $
Penally .... ....,..,......,......,........,.... $
Plul1"blng Pennit Fee ......,................ $
Mechanical Pennit Fee ..,............,..... $
Sewer & Water Penni! ......,......,....,..' $
'.
MATERIAL FILED WITH APPUCA nON
SOIL TESTS 0 ENERGY DATA CJ
PIUNG LOGS 0 PERCOLATION TESTS 0
PlANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o
o
COPIES
'~ )',
~
'4 hour nn.ir~ f..,r ~II t!'l~natl,..'ll"l~r' AA"1 (101:1"\
Speclel Cond"lo/Is K Iny
----
I
City PIIMer
Dill