HomeMy WebLinkAboutBuilding Permit 99-1333
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED n..-I-.". AT
ADDRESS i:D1~1 ISO +:k '3\
OWNER CONTR.
PHONE NO. PERMIT NO. 97- ('533
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
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
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COMMENTS:
fltvw ~ ~ &.Aj ~
cJ2MQ
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)(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAll FOR REINSPECTION BEFORE COVERING
Inspector:
~ Owner/Contr:
CAll 447..9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
~~
DATE RECEIVED
11/5'/9; _
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9q-/.~~'<.,
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1~~31/So >< R(;~
1. DATE
I I -IS- 'If{
/2/S0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
. .-,)
LOT ~
12. NO. OF STORIES
BLOCK
O/-?/<- &tE7J
PID 25--IZ{,v ()()'S.()
ADDITION
13. TYPE OF CONSTRUCTION
4:;0\l!!lER (Nam.).
lreOO?fi
5. ARCHITECT ~ame)
nJn
(Address)
h /3/ /S'o)'l( p.
(T,~ No.)
'Y~7- 7R'6S-
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
8. BUlLOER
(Name)
(Address)
(T.L No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTP
Sass C6>tS'C,.
T. T'IJII;OFWORK
New Constructfon LI
~c,
Fireplace 0
Alterations LJ
Septic 0
Addition Ll
;gO ~ jy,
"'DeckO
finish Attic 0
$CC'P~ V7~-~s-6J
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished infannation 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 10 all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:Uilding Offi~al caf Zth~it~~ore, I hereby agree that the city official or a3~?enterupon the property t~ ~ 'H:/~N'
- Signature License No. Dale
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
I2c S; "y ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS a
SETS
COPIES
SURVEY 0
PERMIT VALUATION
'2 'O(). LFU
PLOT PLAN
Cl
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
City:
Amount Brought Forward .................. $
Park Support Fee ............. .............. $
SAC .........................................4'
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
'7./7
--
\
Plan Check Fee ............................. $
State Surcharge ............................. $
Penahy ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
/.2\
Sewer & WaterPennit ...................... $
Pressure Reducer .......................... 4'
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
~::~'a??7il /tj~~~i~~.;.:ilwh.n prp~1
By!;/'~i1f~r Oat. I flI
. ! I
Certificate of Occupan~
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... ~
Total Due ....m..........mm........' -7t D (/
Paid 71o.(!u R.c.ipl'lo..S& Sl)C)
Issuad e:::.
0.,. /11,- / tltj By
{I , -
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee' 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.
City Planner
Dale
SpeCial Conditions n any
24 hour notice for all inspections 447.9850