HomeMy WebLinkAboutBuilding Permit 99-0323
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULEO
/~-'7~ ~~
ADDRESS
{83 ~ lolJl~ ,SJ:
OWNER
CONTR.
PHONE NO.
PERMIT NO.
c;9- 3;< 3
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING li\l 0 WATER HOOKUP
. q, INSULATION ~ 0 SEWER HOOKUP
)Q FINAL 1& ~ i~ 0 PLUMBING FINAL
o SITE INSPECr(ON 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
D/1
(~ t0~
,
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~owner/contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
!hIS
-----,-'-,--~-,-'"'_...~.-.._--
QATF R~EIVEQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
IWR \ 2. 9J)
Permit No. qC; -3 ?3
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
LOT
J-f, I k~ lit' <;I- 8--
L/
1. DATE
V-l}- f9
KISb
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
i(i~
3. LEGAL DESCRIPTION
/L:,
ADDITION P r ( c '(
12. NO. OF STORIES
BLOCK
5(XL~
PID ,;)5-0 /7 - (J--r'J - (J
13. TYPE OF CONSTRUCTION
i..w..,.aR ~ :.m;.,-u.., t ~ ~Addre~ ~
5. ARCHITECT (Name) (Address)
(Tel. No.)
q 4:- 'l -l{l( ~ c-
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
. ~.'IftIilf:>ER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
OWu~
7.~.OffW$RK Fireplace 0
New Construction 0 Alterations 0
ChimneyO MiSC.~ /
8. PROPERTY AREA OR ACRES
Sq.Ft.
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-l'oofing~ Porch 0
Re-siding ~ Finish Basement 0
SEATS
16. PROJECT COSTNALUE
tu-&. I-l~ 6uJ ~
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
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 property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am ware that the
building 0 icial can revo~e. t rmit fo ju~se. Fu;:l::ore, I hereby agree that the city official or a desig ne.e.m. ay enter upon the property to Pe;qrfO eeded' spections.
X AJ .1 _ ,'- ~
- - - - - l.iclellu !'la.
FOR AOMINISTRATIVE USE
SETBACKS: Required
Actual
Front
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION d<5:0 .()O PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~s f4jr2-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 -If i -K
Permit Fee ................................... $~ ..J_
Plan Check Fee ............................. $ I - "J...~
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Certificate of Occupancy
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ...................................!t
Builder's Deposit ............................ $
Other ......................................... $
Paid ~~u:ro.............~~~~i~:~O$ ;0r'tcr;
Date Ll-i2 -q ?1 By 4 K.MJ
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 reqUdlted. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Issued
City Planner
Date
Special Conditions ij any
24 hour notice for all inspections 447-9850