HomeMy WebLinkAboutBuilding Permit 99-1287
ADDRESS
/.-.5 elL
DATE TIME
SCHEDULED /6 -;')4- /
1i 9] iJ~(/'v &'o-?'-"
CITY OF I'RIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0'- i:;;g/7
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION) /10 r:;::- 0 SEWER HOOKUP
~INAL )<...J,./' 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~ 7J<_o,
)1-wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
={%; ,~'" ,....:::-'~-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
16, PROJECT COSTNALUE
Chimn.y LI Mise, +:,8 1 X J.~ . l/ LP
8, PROPERTY AREA OR ACRES IS, PROPERTY DIMENSiONS 1'0, CULVERT SIZE 17, COMPLE'fiON DATE
SO, Ft. 1 J Q. LQ, 0 Width D.pth Y.s No I'd, - (5 - q C(
[ 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 m~tioned prope . rty and that aU oo~ction will conform to all existing state and loca I laws and will proceed in accordance with submitted plans. I am aware that the
building off" j can rew"'th~s R6nn!t for just se. jrnrmore, I hereby agree ~ the cio/ C)ffjci}l?r ~ ~epJ9,nee may enter upon the property to perform needed insp~?~,
X "1 I iYY\ IJ.IIW 11 ' , Cx' 0 I :J'-1 l'tu -' c). 01 '.:j ~
Sign~ license No. Dete
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ,........................................ $
Collective Street Fee ....................... $
Sewer Tap ................................... $
'$lL 00
6~~ o;'~~:n
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
\0-21- qq
2'TD~~EiS4 L~5q"3
HOJ tly teOUl
1
f:IA&i30f?- Rf..Ae.11
4,Or~~a ( hl'y(Nan~mml \r\lt\ 11'\'Sqy
5, ARCHITECT (Nam.) (Address)
'PlJ SO
3, LEGAL DESCRIPTION
iZ-
BLOCK
PID ;2.5 - 2./:,3 - a 1"2.- 0
LOT
ADDITION
1-1 c{i:Ci 603
(Tel. No.)
6. BUILDER
A2tC-G
l2oQh.m
7, TYPE OF W08!9
New Construction 0
IJ~'63 KU(jIODc. ;qS-od-io
v.3U(nSVll/f,mN~c;~~I. ,
Fireplace LJ Septic LJ Deck a Re-roofing !X. Porch a
Alterations 0 Addition 0 Finish Anic 0 Re-siding ('J / Finish Basement ('J
(Name)
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
$,,",
Side
Baok
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~v U.c1'D
USE OF BUILDING _I2 E S A,!12-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Permit Fee. ..................... ............. -'I:
i4-.7S'"
Plan Check Fee ............................. <t:
State Surcharge ............................. <t:
1.7-e:>
S'i:SLQO
1. While
2. Pink.
3. Yellow
File
City
f~ Applicant
Permit No.
.
qq-/z,~ 7
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heig,t) (Width) (Depth)
12. NO. OF ST~E$
13~dlrr<(1~f:
14. FLOOR AREA APPORTIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS LI PERCOLATION TESTS LI
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
LI
Penalty ....................................... <t
Plumbing Permit Fee ....................... <1:
Mechanical PelTl'litFee ..................... ,<t'
$
Pressure Reducer .......................... $
Meter Hom ........................ ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Du. .............................. $---2.J:...O 0
Paid ""1f#.QO R.C.iPt~,,~,' ..L.fJ, 7
Issued I -.I ~ ~
Dat. 10 Lf!!Iq~ By ~ -
This is 10 certify thai the request in the above application and accompanying documents is in accordance with the City Zoning ~rdinanJe and may proceed a equested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Belore occupancy, a Certificate of Occupancy must be issued.
Sewer & Water Permit ...................... $
.
Thi
By
ing P.nnit Wh.n 1r.:,'t:t1-
at. (()
I
City-Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850