HomeMy WebLinkAboutBuilding Permit 99-1014
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
~ I!/'r
/4L3/0 WftTEJeS6D6G
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-/01'-/
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 MECHFINAl ~ I ;eOo~ .Rdt7'--
COMMENT~:. i?~ .;" (I~
~r... ~ ~ _ ~ffL.
.----:::::::::- .~
(//().f~ ~ ~)
~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~/
~
/
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wf!~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTJ
i7/R;7:;9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
. 2. SITE ADDRESS
<;{- 17-'7'7
AI t ;ttsG
/'1'3 ( "
uA.-kr-, &ley(..."TIJ
e
3. LEGAL DESCRIPTION
LOT I BLOCK
.1;OU.r)//lJS:'
ADDITION
4. OWNER (Name)
y"G ;=/It'''~,?~'n'\
5. ARCHITECT (Name)
.PID 25-t.E/-OO4--0
M/lNOR
(Address) ~ (Tel. No.)
113/& wa.las 1- 7'13- M77
(Address) (Tel. No.)
Kro~5j.J {j,.,d-Jhc
7. TYPE OF WORK
(A~;;j ~ /~JIt~Tel. N~7 tJt'~c;
SePtico~~1L- ~~~ Porch 0
Addition 0 Finish Attic 0 Re.siding D Finish Basement ["'I
6. BUILDER
(Name)
New Construction 0
Fireplace 0
Alterations 0
t. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
91--lo/tj
,
BUILDING INFORMATION
11. 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
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
17. COMPLETION OATE
Chimney LI Misc.
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I hav 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 P rty and that all construction conform to all Isting te and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can re e this permit for just cause. ermorer+t''':lI' a~. at the city official or a designee may enter upon the property tope.neecJtal~s.
X -- __;.~1'l 'J~..?e)I>'~/3 ~- /....-'2:'
license No. Date
Signature
MATERIAL FILED WITH APPLICA 110N
SETBACKS: Required
Actual
Front
- BUILDING DEPARTMENT VALUATION
USE OF BUILDING
RFS ,4/ IL-
FOR ADMINISTRATIVE USE
SOIL TESTS
o ENERGY DATA
o
..ok
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
'2. c:; m
City:
TYPE OF CONSTRUCTlON: I II 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .......... ............ ............. $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ............................... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... ct
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... II:
Collective Street Fee ....................... II:
Sewer Tap ................................... It
$
S U
'14. ,?s
/. Z-r-
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
PLOT PLAN
o
Pressure Reducer .......................... ~
Meter Horn .................... .... ........... $
Water Meter ................................. ~
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... It
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 1 In .0 0
Paid "7{p.(/'\) Receipt No... .1 .5 Y"7q
Date fJ,/r7t:r 7 By,fLtJL- /
This is to cemfy that the request in the above application and accompanying documents is In accordance with the city zonind Ordi~ance and may proceed '5 requested. This document whe~
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
24 hour notice for all inspections 447-9850
Special Conditions if any
Date
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