HomeMy WebLinkAboutBuilding Permit 99-1111
ADDRESS
. OrE . I TIME
SC;:HEDULED ~tG
~-5~~4'!-U~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1cr - (II!
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~'f'-' ~.s&-3
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
~.INSULAT~
u;NQNAL
o SITE INS CTION
c::.C--d>~ f-t L.&
~K SATISFACTORY, PROCEED
o CORREC~A N~ROCEED
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
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PE""O 1 f'ffWit No.
I DIRECTIONS \0 1. DATE -. . IJ
SPACES NUMBERED 1 THfPJ t7MUSTBE FILLED IN c;4
BEFORE '?f'AIT 10 I~UE~~ase Print or Type and sign at bottom) g - 3/- I / BUILDING INFORMATION
12 S'(hSS6 1f)4-- (; G b 8 f/q (" h r l)"e LV PC/sO 1~;i~;~E OF ST~~~J)URE (D.pth)
5~1
5(JS~
7(j.OO
DATF RFr.FIVFQ
L White
2. Pink
3. ,Yellow
File
City
Applicant
9/7/r;
99-)// /
, ,
3. LE";kL .:...::.:...:.,',,', I jvN
12. NO. OF STORIES
LOT
.3
/
.3ty?
PID 25- Zt'l3 - 003-0
BLOCK
)/19.€eoe
14. OWNER f) (Name)
DD/) ,I c j(
15. ARCHITECT
6. BUILDER
13. TYPE OF CONSTRUCTION
ADDITION
(Address)
(Tel. No.)
4 t/<;; -f?"ls I
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
(Name)
I /5g>3(AdRe~ff Or; (Tel No)
Ru/,n.-<;u, IJe..IY1NS5S.J7 8'i5f>>YD
Fire~ce LJ Septic LI OEtk 0 Ra-roofing.e-::. Porch 0
Alterations a Addition 0 Finish Attic LJ Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
A-z1~c.- !fooi'fJ q
SEATS
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
16. PROJECT COSTNALUE
_~o< I 33.5'. 33
17. COMPLETION DATE
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. FI. Width Depth Yes No
I hereby certify that I have 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 prope~ ~ that all con~~~i11 conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding official ~) nni~t ~ ~he~erebY agree ~O ,tygql;/)De may enter upon the property to perf~ ne3/~P9~'
. - Signature" 7 License No. Dale
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
RES ..4/,L.
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
DMsion 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
'74/ 7S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
/,z,
Plumbing PennitFee ....................... $
Mechanical Penni! Fee ..................... $
Pressure Reducer .......................... $
Meter Horn... .... ............................ $
Water Meter ................................. $
Sewer & WalerConnection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Sewer & Water Pennit ...................... $
~:: :r0'J~t;ij~~;I~i~~.;e~it Wh~ Apofp~d
By re::tJlJ /I!JtIf Date q /1111'
, ,
Certificate of Occupancy
T01al Due ............... ............... $ 7 (,. 0 0
Paid 1 (, .0 0 Receipt "Ilt. 3(, CJ 79
Date q /7/ r; q By ..(,j.f'A--..
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 .,.{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,
Issued
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447.9850