HomeMy WebLinkAboutBuilding Permit 99-0522
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DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I a.. 3- 't ~
ADDRESS
s68J I~,~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9 '7- s:; ()
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~t'J1)
')it FINAL ~- I.[J/
o SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
1')
}/
1
~
/~
v
~ORK SATISFACTORY, PROCEED
./ 0 bpRRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /1\.11 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSJVOTJ
s~"
P~b.OO
DATE RECEIVFD
5~O/"'1
\~~
~~
.
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)
125C?~Sl
1. DATE
5-7-1'1
R2-
H II ITS\() Xt.
LOT
3. LEGAL DESCRIPTION
a
OI'lJ::wooo HfLA..$
l:).LOCK
/
PID 2.5 -02.D- ooe-o
400/1.1_
ADDITION
2~
4.0WNE,\ \ ^ (Name) r\,... (Address) (Tel. No.)
"'- \"bnNl \\.\ DY lALtU II'\'. ~~Ib t \-AWI{){\ ~t.. 441-1 bOP]
ISo ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address). p"ell~~}
'()O~ t: , CL\,,ff ed. ""\~DeF \lI-t4
H ll) lAES'Iil ~m.()V'rW \!\SullL6,IMN
7. TYPE OF WORK
Fireplace 0
Alterations 0
c;S 3"D
Re-roofiny!)( Porch 0
Re-siding 0 I Fi~h Basement D
I. While
2. Pink
3 Yellow
File
City
Applicant
Septic 0
Addition LJ
Deck 0
Finish Attic 0
Permit No.
qq- 522...
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
J
J
(Depth)
I 12. NO\ OF STORIES
I ~f.;rr ~;;@'Trl:t~
I 14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEAT~
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. WIdth Depth Yes No
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 aware that the
building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X T.M4a S(~Il.p';v . 'J..oll-fl.9:J~1o r:,)7/0C'J
Signalure Ucense No. I I Date
~ 16. PROJECT COSTNALUE
L.J:'311. ?rQ
. 17. COMPLETIUN DATE
I
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
R'F;s -4/.e..
,
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
2. 5757). oV
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Amount Brought Forward .................. .It:
Park Support Fee ........................... <I:
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... (t
.
S U
City:
71/-.75
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/...is
SOIL TESTS
D ENERGY DATA
o
PILING LOGS D PERCOLATION TESTS D
PLANS & SPECS D
SURVEY [j
SETS
COPIES
PLOT PLAN
o
Pressure Reducer .......................... It
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ..........................................<1:
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
ThisJ9,~OnJ3etom.l ~ing p.nnitWh~.. ~Wf-rl
BY/~7' : Oat. . ~ 113
,
Certificate of Occupancy
Total Du. .............................. L .Zt.. () (')
Paid 7(,.0 0 !=lpt'<>;nt "I^ 3.530 J
Oat. sI!S!q'l. fr-
This is to certlfy that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed Wtequested. 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.
Issued
City Planner
Dale
Special Conditions n any
24 hour notice for all inspections 447-9850