HomeMy WebLinkAboutBuilding Permit 99-1271
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUlnED
IJ-6-1'1
,
ADDRESS
tj(rJS /~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
79-/0<7/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION AI
pi" FINAL /le ~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
nit
r P.,m i?%
v
~ORK SATISFACTORY. PROCEEO
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
~~
1;1E~~f
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.!l tf- 12-7 L
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
"IG.'Z. 5 ~'-"'''\M: ""jb~r.d
3. LEGAL DESCRIPTION
LOT d- BLOCK
..cNO~ #/~
1. DATE
Ir~~ \
e.(
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
ADDITION
2-
2
-v.!?
PID 2S -3'39 - tJflc; - ()
13. TYPE OF CONSTRUCTION
4. OWNER
5. ARCHITECT
(Name)
C. A- lY)
(Name)
(Address)
g '" 7 \..1 s,.(S
(Address)
( ~'dma..)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER
(Name)
(AddreSS)~iP"ll.\'1 r.. I ~ (Tel. No.)
t<--a., ~~ Qr
i'-').h'-"G.-tc>r~ ~,,~ mN ~I.n'~
Septic 0 Deck 0 Re-roofing~ Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT8
rn:.') ...,.....Y"l'\
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. 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 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 rev'te ~ermit for ~se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X '-YT.....V_\ (.,."10'1 10-"'21- """q
-~ignalure license No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
I
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
R-6S "'V.e-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2 S:-CJV. c/V
PLOT PLAN
o
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
7q,~
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... <I'
Sewer Tap ................................... If::
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .................. ..................... $
Plumbing Permit Fee ....................... $
/. 2.- r
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom .................... .... .... ....... It
Water Meter ................................. <I'
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
::w~::~Waterpet7jp:~it.:::::::::.:::::::::::: :
This B. uilding Permit When
By Date 6
Certificate of oclpan
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
7b.O c)
Total Due .............................. $
Paid '7 fa. 0 i) Receipt No. _"3''' d 5" 2-
Issued Date /o/z,/ /s?9 By If~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceectlS 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.
CityPianner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850