HomeMy WebLinkAboutBuilding Permit 99-1392
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
b(p4S" C6.o~;eWooo .s I .
OWNER
CON.TR.
PHONE NO.
PERMIT NO.
QCf. /392.-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL JUIJF
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FIt~AL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
r
/'
/
o ("J
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~~~
~
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/WORK SATISFACTORY. PROCEED
o COR CT ~ON AND PROCEED
o CO ECT 'N fK. CALL FOR REINSPECTION BEFORE COVERING
Inspect: \f Owner/Contr.
a.7J-~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INS/VOTl
QA TE RecEJYE1l
12/2-/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
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)
2. SITE ADDRESS
!J1'1'5 C&{)A-IUJOlJO sr
3. LEGAL DESCRIPTION
~
S/lND
1. DATE
,2-!e-/9c;
PUD
~~ C;;,? <f1-()$' l-d
,
LOT
BLOCK
-3
PID
~ /rt
ADDITION
~/
4. OWNER (Name)
~ !",$,JJ2--
5. ARCHITECT (Name)
(Address)
S~~fi-
(Address)
(Tel. No.)
(Tel. No.)
6. BUILDER
(Name)
(Address) (Tel. No.)
J hO},l) !rr FUJ.4'C, I ~
(~~ PlWalL Lr~ W (.,12- ij"7--1B~'2-
Septic 0 Deck 0 Re-roofing 0 Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
i~ h\~b~
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Cf9-/39z-
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 fumished 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 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 0 icial an revok ili.,pe it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 4~ 00 L/J",6IJ /2- 4'J'N
License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC . . . .. . . . . . .. . .. . . . . . . . .. . . .. . . .. . . .. . . . .. $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2 ~,crU
USE OF BUILDING
K'bS/-Y//L
TYPE OF CONSTRUCTION: I " III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Permit Fee ................................... $
7~7~
Plan Check Fee...................,......... $
State Su rcharge ............................. $
Penalty ......................................, $
I. Z. ~
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
PLOT PLAN
o
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer ..."....,."...,......... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........ ................... $
Water Tap ................................... $
Builder's Deposit............................ $
Other......................................... $
Total Due.............................. $
Paid I (, .0(> Receipt )9p.
~ed A
Date ~/"4-,/ q 7 By '!J~ _
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 s requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificat of Occupancy must be issued.
Sewer & Water Permit ...................... $
Th~ :::;o,ty..... ....l~.;.:n When;"'p~t'.
By t. _ Date Il-/-z, I~ 7
I - I f I
Certificate of Occupanby
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850