HomeMy WebLinkAboutBuilding Permit 99-0989
Q. \\
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUI.ED
i 1.<3'1'1
ADDRESS
0589) ~ Oct.& ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
rtt- 9F9
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO~ __.1 /.J
e FINAL o"'"""D I.t1/
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
I
()ff
d<ru /4.f:P
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/lVl
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
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CITY OF PRIOR LAKE _
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~~;i;1.
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS r ero, I H,' I I
Jl> L dl.ll.bl 00. it: <; Lr r
3. LEGAL DESCRIPTION
LOT.3 BLOCK 2-
#/O//eJJ tJl'1KJ
I q:l; -cro,
~I
j.cr
PID 2S ,073 - ()zO - 0
ADDITION
140 OWNER (Name)
1,';v) I Gt.bOA-h.
15. ARCHITECT (Name)
6, BUILDER A (Nam.) n "
t'f trVl../"" CDv\ vI!; ((1,.(,,-
u,,,+r...dN5 'J
(Address)
1.I,Jrk^
(Address)
a~<; L.'r.
f' g-~ I
7. TYPE OF WORK
New Construction 0
(Address)
/1..-'1-117 N.-~fltf!w<-t;,
&'",rl\.5v(ll-L
Septic 0 Deck 0
Addition 0 Finish Attic 0
(T.1. No.)
t(FfIJ-'7-7PI
(Tel. No.)
(T.1. No.)
7Ct7-bqS~
Fireplace 0
Alterations 0
Rs-roofing'll Porch 0
Rs-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq - "/e9
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSWUCTION
,-<-rp.pp
14. FLOOR AREA APPORTIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PFWJECT COSTNALUE
'tOOO-
17. CoMPLETION DATE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished information on this application which is to the b~st 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 officia])filn revC?~is permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
X "'......-n ---H>'/{;Ci1fi') Y--6-q.~
.. ~ Signature
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
License No.
Front
Baok
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
R.ES 11'L
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
'7 t..{ 7S-
Plan Check Fee ............................. $
State Surcharge ............................. $
I. .2,. S--
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~::~liT{:tp. ..... ......;I~i~~';.:it1J~13V.
By ,'Y'~ Date /1J I ." 7
/
Certificate of Occupancy
Side
Zn5V.cm
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
ParkSupportFee ........................... $
SAC .........................,............... $
Collective Street Fee ......... .............. $'
Sewer Tap ................................... $'
$
Pressure Reducer .......................... $
Meter Horn ................................... $
WalerMeler ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... q:
Total Du. ,................,............ $ 7", OV
Paid 1(" c1Y Receipt~o, .3S8S4-
Issued I I p:::::::.-
Dat. ff II 4'~ By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance an~ may procee requested. 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.
CnyPlanner
Dale
24 hour notice for all inspections 447.9850
Special Conditions W any