HomeMy WebLinkAboutBuilding Permit 99-1111
CITY OF PRIOR LAKE
INSPECTION NOTICE
. DiE _ l TIME
Sl;HEDULED ~tr
G~0t~4LW~
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
crcr - II!!
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~ ~.s&:S
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
,Q.INSULAT;2
~NAL
o SITE INS CTION
c~ - -1>.Q€r <h U;;
~RK SATISFACTORY, PROCEED
o CORREC~A NRiROCEED
o CORRECT 0 ~' .L FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
. v
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
5~0~
7(9,00
~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PE_O 1 fffWit No.
DIRECTIONS 1.0 \ 1. DATE ~ ....
SPACES NUMBERED 1 THfjY t7MUST BE FILLED IN C;
BEFORE ~'''T '0 '~UE~iI')oase Print or Type and sign atbotlom) 8 -.3 / - '1/ BUILDING INFORMATION
2. SITYADDRESS d) /' /""" 6' 8 / I J I I 0 ". SIZE OF STRUCTURE
( h 5 6 't" 4- 1e?::7 n q ('Po r VI" e LV Pus (Height) (Width) (Depth)
3. LEJML. .:;.L:':'~N 12. NO. OF STORIES
Q.ATF RECEIVEQ.
9/7/r!
I. White
2. Pink
3. Yellow
File
City
Applicant
99-/11/
LOT
.3
. BLOCK
)f/l~t30e
/
3~
.PID 25- Zil3 - 003-0
13. TYPE OF CONSTRUCTION
ADDITION
(Address)
(Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
4 'f~--g>'1.5 /
(Tel. No.)
4. OWNER
001)
f) (Name)
leK
5. ARCHITECT (Name)
(Address)
6. BUILDER
(Name)
I / 5g>JAdRe~f fOr, (Tel No)
BUl'flSV' IJ~ . tyJN.?'5337 g9s {)DYD
Septic CI O:lk CI Re.rooflng.e-'"' Porch CI
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT'"
A-zit'~ ~oo{,'fJ"
Fire~ce 0
Alterations 0
SEATS
7. TYPE OF WORK
New Construction 0
16. PROJECT COSTNALUE
_iX,~ 1335_ 3.:3
17. COMPLETION DATE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS 110. 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 property a that all constructi '11 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding official e this nni~t caus ~fterebY agree ~O ?t;gql; 'tiDe may enter upon the property to pert~ :'3J~P9~'
Signature /'. License No. . Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICA nON
SOIL TESTS (] ENERGY DATA (]
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
1<65 ,4/.L.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
BUILDING OEPARTMENT VALUATION
PLOT PLAN
(]
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Parl< Support Fee ...........................4'.
SAC ......................................... <t
Collective Street Fee ............. .......... $
Sewer Tap ................................... <t
<
Pressure Reducer ..........................!I:
MeterHom ................................... $
Water Meter ................................. 4'.
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $ .
Water Tap ...................................4'.
Division 1 2 3 4
Permit Fee ................................... $
/7L/. 75~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... !I:
Mechanical Permit Fee ..... ................ $
/.Z,"
Sewer & Water Permit ...................... $
~:I: :r~;m;~t;.lj:;~~;I~i~~.~e~it Wh.,. Api~~d
BY~) /flItif Date 41? I~ i'
, ,
Certificate of Occupancy
Issued
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. < 7(,. 0 0
Paid 1(,.00 Receipt"W>.3(,079
Date q /7/ q q BY.JAf/L.---
This is to certify that the request in the above application and accompanying documents is in accordance with the city Zoning Ordinance ~nd may proceed al"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.
City Planner
Date
Special Conditions W any
24 hour notice for all inspections 447.9850
- ---~..---r- -.-.-