HomeMy WebLinkAboutBuilding Permit 99-1361
CITY Q~ PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS bS~"J) GSO{! -o{,
OWNER CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
r:rFINAL
o SITE INSPECTION
PERMIT NO.
COMMENTS:
-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEweR HOOKUP
o PLUMBING FINAL
o MECH FINAL
If< QC)..{::::
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DATE
TIME
L (J ~ d 1./-(:1
!'k2- t/!1?Jt / fJL
~~/"'C~
~ ,
- -
- 99-/j',~, /
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
0_
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-
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~ORK SA TISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wo K, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
-
CALL 447-9850 FOR THE NEXT IN~PECTION 24liQURS IN ,ApVANCE.
CODE REQUJREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1ft/SHOT)
"--.-..--. ._- -.-
~ ~ 0< PRIOR
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CITY OF PRIOR LAKE
--- d: , BUILDING PERMIT,
if-"~MPORARY CERTIFICATE OF
: ZONING COMPLIANCE
.'-1. ' ~TILlTY CONNECTION PERMIT
1. DATE
1/ - J3-7'7j:7/~INGINFORMAnON
), I 1 0 __ .' I 11,SIZE OF STRUCTURE
'7q T Por ~'~n::/A' (H.ight) (W",tto) (Depth)
PU';D 12, NO, OF STORIES
PID 25 - 2.40 - nl2..--0 ::z...
I. White
2. Pink
3. Yellow
File
(i:lY
Applicant
,p NOV 161&1
Permit No.
99-/30/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
2, SITE ~D5D,;? /, 5"0 if -6-- {;,;:'i ~
3 lEGAL DESCRIPTIO"" ~~ \. ,-
lOT I "2.- BLOCK ~ I
ADDITION rtA- l? Pr. "C_. =:;f1-t
14, Hq (' fro ~meL/r e LA)
5. ARCHITECT (Name)
,/'l (Address)
LOmm.
(Address)
AOOtJ
/155:.:0, J9Z1-7tJ6:S
I
1WPE OF CONSTR~ION
f<.e..... roo~i?'>C\
14, FLOOR AREA APPORTION!d5NT USE
(Tel. No.)
It~l iTr;{Namel 11 5'83 ~?~ 0" ~,~05 -OD1"O
DO~ "j e. //vrJSI../; /If:"', ,/l1/1) 553,?2
. :L.--- SEATS
7. TYPE OF WORK Fireplace 0 Septic 0 I Deck 0 Re.rootin9't\. Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re.siding 0 Finish Basement 0 16. PROJ;.gT COS))I~L.l}E /
ChimneyO Misc. ;;;:<.. 7,9'/.2(1 ~.-
18. PROPERTY AR)E~RACRES . ~ 9. PROPERlY DIMENSIONS 110. CULVERT SIZE 17. COMPrETION DATE
So Ft .g ff/'O D 5f1 Wid1h Depth Ves No 1;;;( - /5' ,- 9 7
I hereby certify that I have furnished information on this application which is 10 the best 01 my knowledge true and correct. [also certify that] 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
:Ulldlng oi(Xii\Al2Q".hhlt ~~omli:t;s;.mse, Furtheomore. I hereby agr:7~thiCI~ffqal/~Z5nee moy enter upon the property to pei7 ~j3ns~9
j '-'\AIJlgI'I8ture () - . license No. Date
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS D ENERGV DATA D
PILING LOGS 0 PERCOLATION TESTS LI
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12,65 A Ie..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY D
SETS
COPIES
2. '=' () cJ. ro
PLOT PLAN
D
TYPE OF CONSTRUCTION: I II J1I IV
Occupancy Group A B E F HIM
Division 1 2 .3 4
Permit Fee ................................... $
V
R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .....,................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... <l:
Builder's Deposit ............................ $
Other ......................................... $
14,'7 '5
Plan Check Fee ......................... .... $
State Surcharge ............................. !l:
/.2,<;'"
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
This
By
Total Due ,.......,...............,..,.. $ 71.,00
Paid 14> ,0 () Rece;P1tc. 3.0 S'3e
Issued
Date I Ii 10 {q q By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as~quested. 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
Date
Special Conditions ij any
24 hour notice for all inspections 447.9850