HomeMy WebLinkAboutBuilding Permit 99-1109
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
It) -zz-1'1
A,'I;
ADDRESS
]1 Co 5"
t!o.-k ~ s. cJ .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9'7-//~9
o FOOTING o PLUMBING RI o EX/GRAD/FilliNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
? FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL /1{ d-;J
COMMENTS: I?~ ,.;. ~
0
",,-.... ~ ~r - ---
(( ~LJ;J( ~ ')
-
/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~~L FOR REINSPECTION BEFORE COVERING
'nspector: . f:;::/ ./ / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
__....~_..~__._._"'"._,_____",....,_.__.__~__.___~'_.....__.___._...._..._..._n._._____
~~
;7;797
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Y\22-l,o
,1/-
1. While
2. Pink
3. Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at botlom)
/2 SITE ADDRESS 31lt:6 Vt\;~ Lie
Permit No.
C/9-//0'l
1. DATE
B'/1o'4'1
,e ISD
BUILDING INFORMATION
11. SIZE OF STRUCH';H~
(Height) (Width) (Depth)
lOT
3. LEGAL DESCRIPTION
1- 2-
BLOCK 32-
SP,eI/VtS tA;::..6
\AfJ.d'l'~S)
311d5 valjAiru.
(Address)
12. NO. OF STORIES
PID
25 -133 - ()37- ()
14. OWNfR.' d (f'ji'~'fl:{\
L.1V\ It I..U!-rMa Y\
5. ARCHITECT (Name)
(Tel. No.)
#1. 1.P1~D
(Tel. No.)
13. TYPE OF CONSTRUCTION
~.~
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Name)
Ul{~ ~ It"{..
OCCUPANTS
7. TYPE OF WORK
(AddreSs)~V1SVLlI~.r-L No.)
~ 1zt11Ave; ~. \?qs.q~le
Re.roofing}r" Porch [j
Re.siding 0 Finish Basement 0
'. 15. NUMBER OF OCCUPANTS OR SEATS
New Construction 0
Chimney 0 Misc.
/8. PROPERTY AREA OR ACRES /9. PR PERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 pro rty and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. r am aware that the
~U;ldi . .al r k ., lor .usl cause. Furthermore, I hereby agre~~ Ti:~ Oq~ or designee may enler upon the property to pe;:"." t"7",:e2i':!/ections.
license No. Date
Deck D
Finish Attic 0
SEATS
16. PROJECT COSTNALUE
15J~__~
17. COMPLEllvl'v LJi\ r l::
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
,€6S A//.2.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: J II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
City:
Amount Brought Forward .................. $-
Park Support Fee ........................... $-
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ... .... .... ........................ $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
~4. 75
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.......................... ......... .... $
Plumbing Permit Fee ....................... $-
Mechanical Permit Fee ..................... $
/.2.6
Sewer & Water Permit ...................... $
~~:~~f~~~~~~:t;"WqtrI1l7
/1foYV/ , I
Certificate of Occuparfcy
7{". 0 0
Receipt Wl. .3 (,0 78
Date ';'/7/9&1 By 1B..-
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..ts 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.
Total Due .............................. $
Issued
Paid
7"'.00
C~yPlanner
Dale
Special Conditions it any
24 hour notice for all inspections 447-9850