HomeMy WebLinkAboutBuilding Permit 99-1259
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEb
ADDRESS
/ SStjl /'I<A~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ./Jjf)
)!f FINAL fiATlJ"O (!J/
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~ 1_
()f1
d~ fJP
DATE TIME
/6(-71:1
1j'-/t2-)'1
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~RKSATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~ Owner/Contr:
,
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
DATE RECEIVED
It('
CITY OF PRIOR LAKE ~5f.
. BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
I. White
2. Pink
3. Yellow
File
City
Applicant
10//9/9''7
91'-/259
I
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12 SITE ADDRESS /'!JSq I J..1 /4 h ItWlJ ..4J~
1. DATE
;O-f/?-1C?
,€./SD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
v
12. NO. OF STORIES
LOT
o
I
PID ?~-/4_:;- ()(?(,,-o
BLOCK
/C;L/,INO V / 6l..u
14 OWNER 04j/a/;;,'J,6
15. ARCHITECT (Name) ""
6. BUILDER (Name)
(Address)
IS~tj f H'ji, /c."of.....A/{J
(Addre
(Ter. No.)
13. TYPEOFC~TRUCT10N
('-( ("""("/nfI
14. FLOOR AREA APPORTiONMENT USE
ADDITION
Jrl
(Tel. No.)
(Address)
(Ter. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
A~/:cc.C\ fl/o\:!rJ:,,; 4,.,jrtAd"'5 1'7- Wt'///,'coltJ.f -4..;.,. '7..07-{;'1511_
7. TYPE OF WORK replace LI Septic 0 Deck 0 Re-roofing" Porch 0
New Construction 0 Alterations LI Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement a
SEATS
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. 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 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. ~7fV~O is 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 +:--~ '-0/6 ~> &":l 1t:J-1 r:.:-Cl'"
,,, Signature License No. Date' /
1~OJECT COSTNALUE
.~#?a-
17. COMPLETION DATE
..J
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
2{::;"S' ;:rJp_
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2~o. fJ'O
PLOT PLAN
Ll
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... <t.
S U
CiTy,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
-7<(. /_\
Plan Check Fee ............................. <t.
State Surcharge ............................. <t.
Penalty ....................................... $
/.zJ-
Plumbing Permit Fee ....................... <t.
Mechanical Permit Fee ..................... <I'
Pressure Reducer .......................... $
Meter Hom .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... <t.
Gas Rreplace P: rrnit ....................... <I'
tJlding Permit When ~Proirtv C;
/\ Date /O//t; ';1
. /
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7(".0 ()
Pa;d 7"'. (/ 0 Receipt ~. -S'& "f-+ 0
Issued
Date/tJf~/C;c:; By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance ami may proceed)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 Oca.lpancy must be issued.
C~yPlanner
Date
Special Condrtions ~ any
24 hour notice for all inspections 447-9850