HomeMy WebLinkAboutBuilding Permit 99-1132
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I" -/9 -n
A. "'-
ADDRESS .-/.c::; h R"(l
v~~'
CONTR.
OWNER
PERMIT NO.
-
99 -//3 G
PHONE NO.
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 sEWER HOOKUP 0 FIREPLACE FINAL
/It'FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
/0 SITE INSPECTION 0 MECH FINAL J( ~
COMMENTS:jJf~ ~ ~
-( (~ ~
-
-
/'
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, owner/Conlr
CALL 447-9850 FOR TI'E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
~\
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
File
City
Applicant
1. White
2. Pink
3. Yellow
DATE RECEIVED
9/14lf,1
Qq'-//3 Z-..
Permit No.
1. DATE
DIRECTlDNS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
/5(/;80 -HIGJ.hA/ln) AVE. s.
q1N/99
1<-1 sD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
J.
13. TYPE OF CONSTRUCTION
7E"f412.. &I"'r I ~Gbcr
14. FLOOR AREA APPORTIONMENT USE
3. LEGAL DESCRIPTlON
q
2-
Iff
PID 2.5-/43 - CJZ8~O
'LOCK
VIE:!-\.f
LOT
1St-
ADDITION
(Tel. No.)
d-/%-<f'I 'l-S'lZ'f
(Tel. No.)
(Address)
SIfItlE A-S Ir&x/G
(Address)
4. OWNER (Name)
THt;!I11IiS SJfV() V
(Name)
5. ARCHITECT
15. NUMBER OF OCCUPANTS OR SEATS
(Tel. No.)
~/2. -
~O - '1730
(Address)
I7CPI ASH P.,Mr A$.
SE"" IC~
j!lPf04 lAk:E. nHJ.
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing P- Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement LJ 16. PROJECT COSTNALUE
ChimneyCl Misc. -If 3130.00
\8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No 'f / / S /'19
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 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .R"/u,~ .J:(J~.r ' . 201 731f-7S . '1/1'1/'19
Sign~atu~ LICense No Date
(Name)
ZNl)tJ..S."eI6 S
6. BUILDER
IJRIZt!.
OCCUPANTS
SEATS
---
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICA TlON
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
Side
Side
B,ok
Front
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
BUILDING DEPARTMENT VALUATION
SETS
COPIES
PLANS & SPECS 0
SURVEY 0
;eE~ R/;C
USE OF BUILDING
2.51JV, c5D
Cl
PLOT PLAN
Amount Brought Forward .................. 't.
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $.
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... ~
Water Tower Fee ........................... $
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
7'-f-1r-
Division 1 2 3 4
Permit Fee ................................... ~.
Plan Check Fee ............................. $
I .'1..(
State Surcharge ............................. <t
Penalty....................................... II:
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... It
Sewer & Water Permit ...................... <t:
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1'-.00 Receipt ~.q.
Date qliC//t{q By JdVL-
This is to certify that the request in the above application and accompanying documents Is in accordance with the City Zoni~g Qrd(nance and may proceed Is requested. This document wilen
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.
. ............... $
r Building Permit 'ffl)h!).~d.
Date ..:!.fl.!!.f-'fv I
This
By
/{,.OU
.3 ~ z,o'L
Certificate of Occupancy
Issued
Special Conditions W any
Date
City Planner
24 hour notice for all inspections 447-9850