HomeMy WebLinkAboutBuilding Permit #99-0301
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
~ .3:00
6b7( t'VOCJDSI06 /CO
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~9-30/
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o EXC/GRAD/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
~
/'
'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W CA FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspector:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
.. ---..~-_.,.._,_.".,...,.._-_._"-
04/02/99 FRI 12:19 FAX 6124474245
CITY OF PRIOR LAKE
141 001
~
" . ./
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DIRECTIONS
SPAces NUMBERED 1 THAU17 MUST ee FILLED IN
BEFORE PiAMIT IS Issueo (Please Prim or Type and sl9n .ll bollom)
a. SITE ADDRESS
DATE RECEiveD CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. While
1. Pink
3. Yellow
F;l~
Cil)>
Applk:anl
Permit No.
9'1-30/
1, DATE
SUILDINC INJ:ORMAnON
11. sIze OF STRUCTURE
(HAighI) (Wi",,,) (Depth)
LOT _.".
AODI110N
4, OWNElR
.zs- BLOCK
{Ja t( (mrl 1-!-;/'/5
PID
ds -o.r f - DDS =!L
1~, NO. OF STORies
5. AACMITECT
13. TYPE OF CON$'I'RucnON
14. FLOOR AReA APPORTIONMENT USE
(Name)
2.
(AdOr_l
(Tel. No.)
6. eolLOSR
(Name)
(Address)
(Tel. No,)
7. tyPEOFWOAk
NQw ConstnJodoo 0
Chlmnl(ly CI Mise.
8. PROPERTY AFleA OR ACA S
Sq.. Fr.
s
15. NUMBER OF OCCUPANTS OF! SEATS
OCCUPANTS
SEATS
Wlclll'l
Oeplh
Ves
No
17.
I hf.lleby cortify thar I hall6 ftJrriS/1ed ImarmanlJl't Olllhis appliclltlon INt>ioI'1 ill 10 the best 01 my knowle(lgc. true and eOll'eCl, I alSo cenlfy ItlCltl ilm the owner or aulhori.ted agent for
the above mentloo<<l property ana lnat all cOI1suvC1!oll ....111 conlorm 10 all exlSlIng Sll1l8 and Ioc<ll laws end .,,111 proceed in secordnne. with aubmll1sd p1an$. I em ilWllre 1lI111 Ine
building 0/1' n ravoko thill erm;11 81 c:aUS~. Funhermore. I rlerllby agree 1081 the city olrlClaJ or a d9lignee m"y QI'ller upon Il'te propel1y to pelfonn nGElded InqcfOn&.
X ~ ~.7~'f -4-7S-
L.io:;or.sa No, DeIo
FOR ADMINISTRATIVE USE
SETBACKS: RequIred
Actusl
"ran!
9&ek
Side
Side
MATERIAL ALED WITH APPllCA noN
SOil TESTS 0 eNERGY DATA "'
BUILDING O!!!PARTMENT VALUATION
USE OF BUILDING
;eG"1"~~
OFF STREET PAf:lt(ING
SPACES Reo,
SPAOES ON PLAN__
PERMJTVALUATlON
PIUNG lOGS CJ
PLANS & SPECS 0
SURvey i"l
PLOT PLAN I')
PERCOLATION TESTS 1:1
SiTS
COPIES _
lYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B. E F HIM R
Diwlsloll , 2 J 4
Permil Fee ..,.....,...........,............,. $
s u
74.75
City;
Amount Brought Forw;,rd ......m....'.... $
Park SUR:>O" Foo .....,..................... S
SAC .-.----......-.......,...................1
Plan Cllsc:k Fee .'............._....._.,..,.. S
SUIte Svrcnarge ........,...,.......,......__ $
PenallY ...................,_.................. $
PIU~9 Pennil Fee ....................... $
Mechanical Permit Fee ..... m.._.......... $_._
/.25
ColleClive Street Feu ......_................ $
5ewerTep ................................... $
$
Se....er & Waler Permlr ...................... $
Pressure FllIaueer .......................... $
MeIer Horn '....n____mn_.... .............. S
Water Meter ..........__........,..........., $_.
Se....er & WOller ConnAcllQrl FM ........... $
WalerTowel' Fee .... .._.._................. :>
WlIterTall .......'...._.n..............._... $
Builders Dep06it . ...___._.... ............... $
Other............... .._................ ....... $
Total Due ......................._...... S
PJ;lid Receipt No.
Gas Fireplace Perml1 .............._m..... $
Th~ Appllcadon ~orTIes Your I!lulf"ing Permi! When Approve".
B'{ _ Date
CIillTIfiOltfj of Occupancy
Lssued
D.ttre
By
Tt>!s is 10 cernly IllIlI Il'le raquEIliIIn the abowl applic:alion and accompanying dOl1llTlenls Is In aceotdallCe whh lho City ZC!li'lg OrdlllllC'lCe and may proceed i$ r e&lecI. ThIs OOcumenl When
signed bl/lIlO CIty Planner <;M$lllul<l:a a IIIIl'CICOlY Cenllleale of Zoning corroll~nClJ and aJlOWll consrl\JCtlon to comrnerlCe. 8elorfll)CCupe1lCY, a Cel1illcata 0' Oalupancy ......Il be 1a8ul,Cl,
cny Plan....'
Os..
SIlGCI~1 CondlliOl\s il *"y
24 hour ""'Ice for ..II inspeetlOl'ls 447-9l15O