HomeMy WebLinkAboutBuilding Permit 99-1217
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULE'iD
ADDRESS
( (,930 1JJJ.N.Jt ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ..../ /Ii)
~ FINAL """.IlAJtr 0 Il:V
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
"Iv
Ur~
Jhu; M
DATE
TIME
/Jd/r9..
<[~-JJJ7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~ Owner/Contr:
Inspeelor:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
--..-.--...-..---...--...-----..-----.-------..----.----
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicallt
Permit No.
99...../2../7
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12S~%t; =30
3. LEGAL DESCRIPTION
3
/i/~6~c;9'
ADDITION
4. OWNER
i'"\ (Name)
UIJO-P
/ / 1..-. tv t:/ y:-
2-
f1! It..LOlA/S .s ~
/ ,0 (AddreSSlj
t.(/I,-P / A
~(Address)
Jhl;O
.
Rr
BUILDING INFORMATION
, ,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
lOT
BLOCK
PID
Z5-//0 - Od7-{)
13. 7?.;. /);';/0(1
r:;(J(:) SI3s -14. FLOOR AREA APPORTIONMENT USE
H.~
5. ARCHITECT
(Name)
(Tel. No.)
6.BUllDER 1_. _:Nam.)br~ C;::;;r LL.-i~ /1~J7-2.vr2.) 15. NUMBER OF OCCUPANTS OR SEATS
f'i-Vn 17 1/] l('::;- Otl-h T~ .-;;:- J:;,"-d- .A.- _ OCCUPANTS
7. TYPE OF WORK Fireplace 0 Septic 0 Deck i'J Re-roofing~OrCh 0 i SEATS
New Construction 0 Alterations 0 Addition 0 Finish Attici'J Re-sidingD Finish Basement 0 116. PROJECTCOSTNALUE
Chimney 0 Misc.
la. PROPERTY AREA OR ACRES 19 PROPERTY DIMENSIONS 110. CULVERT SIZE 117. COMPLETI~DATE C;;
Sq. FI. Width Depth Yes No I a - "-;?' r r 9
I hereby certify that I have fumi hed infQJ1l)at1t571on ~ / lcation 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 pr ?:t ~t:". __, _..ww will conform to all existing state and local law~an proceed in accordance with submitted plans. I am aware that the
building official can re e . pe It for just .e, I hereby agree that the.city official 0 d,~nee may enter upon the property to perform needed ?~.
X /'.-< t'9-r? ,/-P ./0 -n ~'T9
, {Signatuy / license No. Date
-
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING lOGS LJ PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/<!.ES ""/=-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z~ou.(JV
PLOT PLAN
LJ
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... q:
Collective Street Fee ....................... <t
Sewer Tap ................................... <t
$
7t..(.7!
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/.~ r
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Hom .................... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Mechanical Permit Fee ..................... $
~:: ::~i~j~~~7;fiit~~.~..:n WhO"f7tC,
By '17Z~ i ~ Date J, 0/
7 /
Certificate of Occupancy
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7 t, . cJ ()
Pa;d /' fP. 0 Ci Receipt ~;>. _ 3' &, Z- , !,-
Oat. /0/0/"'7 By IJCL---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce ~nd may pr0ceeq,4.s' 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
Date
Special Conditions if any
24 hour notice for aU inspections 447-9850