HomeMy WebLinkAboutBuilding Permit 99-1286
CITY OF PRIOR LAKE
INSPECT!ON NOTICE
ADDRESS
l/;90-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o )NSULA'f19N",vr~
)Zf FINAL (1 f.A./' (
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED / t1 ~ ?.l-f-)
7~J- - 9 if ~~'?j /je(JjJ--
CONTR.
99 - I.~I) ~
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
f//r2f Yo
\!WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORKfl'LL FOR REINSPECTION BEFORE COVERING
Inspector: I/3;r- ( , Owner/Conlr:
I
C::.A1..'_ A4~-9B~D FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTJ
~. '~~ (Name) IJS~3 Rvtd,esfJr: 89S-otYID
OO~4 J3vrr'lS UI-7 k rYJN,553'$.7
. TYPE OF WORK'-" Fireplace 0 Septic 0 J Deck 0 Ae-roofingAr'" Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re.sidlng 0 }:;Inish Basement 0
Chimney 0 Misc.
8. PROPERlY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. '19(;) Width Depth Yes No
I hereby certify that 1 have furnished inlannalion 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 .."..:...,: property and that, all co"':~tion will conform to all existing state and local laws and will proceed in aceo"",nee with submitted plans, I em eware that the
:uilding oit{~i;~~lFl1yt i~rl,JK~r' I hereby agree;;''De.?3Q"/ ~})e may enter upon the property to pe/t1 n~~ i7~9
. SignatutJ. J I License No. Date
DATE RFCE1VED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
oel 2 'j OOU
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE ALLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
/O~7-f~~
J,~9D~6,592 ~b5'1LLffirhDr &:Prc...A
3, LEGAL DE'SlFi,PTlON
q BLOCK { PID 25~~- Q/')q~
~€.A~
plJt3;
LOT
ADDITION
4"fkER I. (Nam~ '(idd'...) A
/,,oD c wpm m tN) I 7'V S>l:>C.
5, ARCHITECT (Name) (Mdress) .
(Tel. ~ ct
f~o) ""92)61
I
5:2s'lfO
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq-/z~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Wldth~ (Depth)
12. NO. OF STORI~
':(f ;kCON~~~o.r~
14, FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECTCOSTNALUE R
S3,07~, ()
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL ALED WITH APPLlCA nON
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
7.....00.0"0
.
USEOFBUILDING ~E:.S I1fJ2-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
SOIL TESTS
o ENERGY DATA
a
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS a
SURVEY 0
SETS
COPIES
PLOT PLAN
a
Permit Fee ...................... ............. $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
74-.7'5
Amount Brought FOlW8rd .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ............. .......... $
Sewer Tap ................................... $
S U
City:
I . -z..s-
$
Pressure Reducer .......................... $
Meter Hom ........... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $_
Total Due ............................., $ 7fA.0 0
Paid -7t, .0 0 Reeeip '3
-, ~~ U
Date I 2. 41 BY"~_
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordine and may proceed requested. ThIS document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and anows construction to ""'.,,,, ":,,,...,J. Before occupancy, a Certificate of Occupancy must be issued.
Sewer & Water Permit ...................... $
This
By
...................... $
uilding Permit 't'~n/~P.l~
Date~
CityPtannef
Dale
Special Conditions ~ any
24 hour notice lor aU inspections 447-9650