HomeMy WebLinkAboutBuilding Permit 99-0850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SC,HEDULED /d -22-99 A.T;
ADDRESS ~/ t. 9 ?J~I .<~,"'-'t ~.
J
OWNER CONTR.
PHONE NO. PERMIT NO. q 9- 5?s-o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)iD FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL ,.. ~
~tSo ~ r
6
~
( I/j'~
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~
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-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S:::O:ECT W~ ~ALL FOR REINS::::/::n::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'.,DATE
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Ii _ ADDRESS
tI J f/}
i,J:A<!SNlf /;rde
3. LEGAL DESCRIPTION v'
LOT'~ BLOCK
ADDITION IA ),VldSiJvlc/ 1'Jy]
4. OWNER (Name) J
'K..v. II
(Name)
5. ARCHITECT
%~-
ji..jlUjlDER
(Name)
~=..~~ ~~~ep~~
Alterations 0
7- ~ -'11
d
+tw fA Ke
PID d')-,J3{, - (x:e-o
1. White
2. Pink
3. Yellow
File
City
Applicant
(Address)
illlA U. ,,jSDW( (:~d(
(Address) J
(Tel. No.)
Permit No. W-f'sV
BUILDING INFORMATION
". 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
tll.I'ROJECT COSTNALUE
""7,700_, (15)
17. COMPLEilON DATE
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation 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 m~n. ned 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
bUildiZ~ia revoke"" pep:;t for jU1 caus,e. .Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X . LJ. ~ dOt "''l~.3'1 ,-<;(-9.,
I _ .. .-.eNo. -
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
/!
0smt
USE OF BUILDING
(Tel. No.)
(Address) (Tel. No.)
- !l . k .1 Ilft.~' .r-
t{;M<o VI--s.lkr ,.4<-:;!1vI &u.J. -,/ 3.$.-9.>>11>
Septic 0 Deck 0 V Ite-roofin~ Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
dsm. cG;-
TYPE OF CONSTRUCTION: I It III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee. ............. ..................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $.
Gas Fireplace Permit ....................... $
MATERIAL FILED WITH APPLICA TlON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
{LI_ 75
I. ;).G:
AmountBroughtFolWard .................. $
Park Support Fee ........................... $
SAC ......................................... ,It
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
City:
Pressure Reducer .......................... $'
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
This Application Becomes Your Building Permit When Approved.
By Date
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ -/ L()
Total Due ...D......................... $ (I??_
Paid / t, . 0 Receipl No. ,::SS0 3S-
Date1 "l-Y7 By {J.;!uJ
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 requ~ed. 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.
Certificate of Occupancy
Issued
CilyPlanner
Date
Special Conditions ~ any
24 hour notice for aU inspections 447-9850