HomeMy WebLinkAboutBuilding Permit 99-1291
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/s {rJ.~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION. 61
:II FINAL ~ VJ/
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
(j ;1";
,
~ ~ ./dJ
DATE
TIME
7'1-ldrl
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORKSATlSFACTORY,PROCEED
, ~'bORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Cantr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
_._.._--.__._-.._.~.-
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CITY OF PRIOR LAKE
. BUILDING PERMIT, .
TEMPORARY CERTIFICATE OF .
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No. -q~-/4
QAIf C!I::::r.I=IVI=D.
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DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1. DATE
dFZ.- <t'-'1ot
/::;-6"7...1
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~
N~
ikiSV}
3. LEGAL DESCRIPTION
12-
(
VIf::;.W
PID
Z <'--1<13 - (JI'? - 0
BLOCK
/51/
LOT
/J r
ADDITION
4. OWN~ (Nam.)
\.I Ol~ \cJ.:IJ,~
5. ARCHITECT (Name)
(Address)
1 ~t;'L'1 H ~~ b "J /!r.J~
(Addres
(Tel. No.)
(Tel. No.)
(Name) (Address) (Tel. No.)
, 1'1..",.{7N,<..!&.f Avt <;".
,AJ:tUI'(.M rJv...lJ.-/oA {t>IIJ.,..Jf/(I 70-6'1>'2
7. TYPE OF WORK Fireplch?e 0 Septic (] Deck (] Re-roofin~ Porch 0
New Construction 0 Alterations CI Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement 0
6. BUILDER
1. White
2. Pink
3. Yellow
File
City
Applicant
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CCjfJSTRUCTION
,r ~ r?,?'fI
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCGUPANTR
SEATS
716 PROJECT COSTNALUE
S:SOO~
17. COMPLETION DATE
Chimney LI 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 submined plans. I am aware that the
buildin~~al ~~oke this permit for just cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to perform needed inspections.
x/__-~f ->....t7/,6Cf-r,<?, /t7-7.-~-q'l
Signature License No. Dale
FOR ADMINISTRATIVE USE
Amount Brought Forward ...........,....., $
Park Support Fee ....,.,.,.,.,........,...,. $
SAC .........................................$
Collective Street Fee .,.,............,.,.,.. $
Sewer Tap ......,.,.,..........,.,.,.,.,..... $
$
Pressure Reducer .........."............., !l:
Meter Hom .,...,........,.,.,.,...........". $
Water Meter ........,.,............,.,.,..... $
Sewer & Water Connection Fee ........." $
WaterTowerFee ...".,.........,..."..... $
Water Tap ....,.,...,........,.,.,........... $
Builder's Deposit ............".............. $
Other ,..........,...,..,.,.......,............ $
Tolal Du. .............................. $ E" . CJ 0
'/1. .()u R.C.'Pt~O.. (n4-7)
Issued
Dat. /0/ urj r;q By ___
This IS to certify that the request In the above application and accompanYing documents IS In accordance With the CIty ZOOlng ~rdlnance and may proceed as uested 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.
SETBACKS: Required
Actual
..ok
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2 <;'Lfl) , ([LJ
USE OF BUILDING
as nltC--
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee .,.........".................. .... 0;:
-?L.f. 1 J'--
Plan Check Fee ............................. !l:
State Surcharge ............................. $
Penalty .............................,......... l/::
Plumbing Permit Fee ......"............... $
Mechanical Permit Fee ..................... $
/.u-
Sewer & Water Pennit ...................... $
Gas Firep
P: rmit .....,................. $
,Idlng P.nnfi Wh.mjri c;
Dat. I ~
This A
By
Paid
Certificate of Occu
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
24 hour notice for all inspections 447-9850
Special Condilions ff any
City Planner
Date