HomeMy WebLinkAboutBuilding Permit 99-0287
t'
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SC DULED
~ t:1ffJ
ADDRESS
5"313
/ t/ tJ tf:.
PHONE NO.
PERMIT NO.
~z.n:;:- J
~~'
<t' '/7
qq/d~' ,
OWNER
CONTR.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
1jJ) .8 WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP I r:. 0 FIREPLACE FINAL
@ il PLUMBING FINAL ~(2) 0 GASLlNE AIR TST
/0' MECH FINAL 0
,.
COMMENTS: (j) ~ ~.
~/~-~~
..A-4J,.. ~ ~ "--,
~
I
..~\ \f "\
!-.......~ - -
~ --
~. ..-e
22,;1\ ~. ~
IV I
~.~ J 1~-tC-~ - ...;c...a-(tl
~ _~~ ~ ~ -Ie t>>-<LI~,
~ I'~ ~r i.4 tr1- .t
o WORK SATISFACTORY, PROCEED ~L 'Iv Ct.:~~
,,"CORRECT ACTION AND PROCEED ~ ~
o CORRECT W~K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr: r
9ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
I i Ii I
.
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc. ~ ~ - W"'-~_ U .1 c,... l rtJ
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS , 1 O. 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 c truction wi)1 conform to al xisting state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official c revoke this ermit for just I!se. Fu r e. I er y agr e that the city official or a designee may enter upon the property to perform needed inspections.
, ~
DATE RECEIVED 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
4 -& -q q
2. SITE ADDRESS
5~ '3.- \I.H~ St 1J ~
3. LEGAL DESCRIPTION
LOT ,3 BLOCK
A~6;-~ ~ ()~
.4. OWNER ( ame) (l (Address)
( rr ~M-~
5. ARCHITE (Address)
,,,,------/
'-.. -...-'"
6. BUILDER
PID 2.JJ-(f) f..JL, --lYD'S-o
IJ~ ~
{g ~T; ~~~ -0 ~i
(Tel. No.)
(Name)
(Address)
(Tel. No.)
License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
..
USE OF BUILDING
(i./pc" .
I
lJP-
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A B E F HIM '<.B:J S U
Division 1 2 6 4
Permit Fee ................................... $
I. While
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq - 2B 7
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $.J.J\ C:;-{j .0 C>
Collective ,~treet Fee ....................... $
.. '50 j(<rJ0Tf!.: ~ Ie> Sewer Tap ................................... $
. IVI"'"' DC- f'-'\b> ~ $
n~DF- P~I"'\. rr Pressure Reducer .......................... $
. Hf. ~ ~.,eterHorn................................... $
.1J 12 :I~(,e/) . Water Meter .........................6&:... $ l 2t:;.oO ,
~ v: -::;DII,U Gewer & Water Connection Fee ~-DT6 $-4 ? 00 .d ~:
~loP ~t;: ::::~~:;e.r.~~~..::::::::::::::::::::::::::: : ,6 rJ .~ D
JI'l~l!:sr- Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1. 'l. 2e . GO Receipt No. 34- ~,
Issued " f { ~ \
This is to certify that the request in the above application and accompanying documents is in accordance with the c~:;oni:dr~an1 ~t may pr:~d ~~~ed. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permn ...................... $
............ $ ..
'Iding Permit 'ljfej ~,!ed.
Date ~
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
T
- "Y
LlS.oo
'311,0.50
I .