HomeMy WebLinkAboutBuilding Permit 99-1361
CITY Oi' PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS (?'50,~,
- I
(.; SOL) -()f:,
CONTR.
OWNER
PERMIT NO.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
cYFlNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
R (X)+:::
COMMENTS:
cL~ ~-
DA.TE TIME
/0 - (). L!~-(> I
rll (J , 0)
Yi-OAJ::/OZ/ r V
Of(/' ~~
qQ-/3(;." /
-,
o EX1GRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WflK. CALL FOR REINSPECTION BEFORE COVERING
Inspector I~ I Owner/contro -
CALL 447-985D FQR, THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
I. White
2. Pink
3. Yellow
File
(~.s:y
Applicant
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 bottom)
2. SITE ADDRESS
(,5D;;),
3. LEGAL DESCRIPTIO";
/, 50 i -6--b5~
~ ',,:.
~~ I
12. NO. OF STORIES
.2..
1"2-
ADDITION HA e t=Sr"> .e..
4. ifqR r ko ,;me//t. e LA~
5. ARCHITECT (Name)
LOT
'WPE OF CONSTRyqION
/<.e ~ rc:,c>~i",(j
1 4. FLOOR AREA APPORTIONMPNT USE
(Tel. No.)
l/;2iTr;(Namel II ')&3 ~~7p 0.. ~':705 -ODl'O
R D ()!:{', () C, if31~ v/1c:,v i / !'(? .)1111) 553? 2
7. TYPE OF WORK r.../ Fireplace 0 Septic 0 ~ Deck 0 R8.rooiink- Porch a SEATS
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re.siding 0 Finish Basement 0 16. P, "l ROJECT CO~' ~Ui, E., /
Chimney 0 Misc. 0<. q Q ;:y/ ~
/1/ ...
8. PROPERTY AREA OR ACRES . ~ 9. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE --
Sq, Ft. '!? I? 0 D 5f1 Width Deplh Yes No I;: - / 'S.. ;; 7
I hereby certify that I have fumished infonnation on this application which is 10 the best of my knowledge lrue 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 submitted plans. I am aware that the
~Ujkjing OK XiAn1lRehir ~~~irKj~se. Furthermore. I hereby agre8o? ~i ci3~al/yi)nee may enter upon the property to pei7 ~i3~~9'
J """"'-"'VLn8lure 0 - , license No. Date
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
B.ok
5ide
Side
I MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12..5s II Ie..
OFF STREET PARKING
SPACES REO
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2-"=' 0 u. m
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II HI IV V
Occupancy Group A 8 E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City'
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
14."7"5
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
1.2..S-
Certificate of Occupancy
Builder's Deposit ............................ $
Other ......................................... $
Tol.1 Due .............................. $ 710.00
PaId I~.O D RecelPlfo. 3", &3 e
Issued I I
Dale I( 1'1 qq By
ThIS IS to certify that the request In the above application and accompanylOg documents IS In accordance WIth the City ZOning Orcllna:X:e and may proceed a 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.
$
Pressure Reducer .......................... $
Meter Hom ... ................................ $
WalerMeter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
This
By
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447.9850