HomeMy WebLinkAboutBuilding Permit 99-0430
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PERMIT NO. fJ qq-/~55
f\ X PLUMBING RI 0 EX/GRAD/FILLING
A 0 MECH RI 0 COMPLAINT
~ WATER HOOKUP 0 FIREPLACE RI
A ~SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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Inspector:
DATE TIME
SCJ.lEDULED
/jv,l97 L15.
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Owner/Contr:
CALL 447-9850 FO' ~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE,QU/REMrTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
V IN$NOTl
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QATE R~~ 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)
2. SITE ADDRESS C;[7 9' r
Jc./ ;:? /I/(j tb 5-1-. II/c~
3. LEGAL DESCRIPTION
1. DATE
'1~zc- qq
LOT
-,
,
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N~.<:::"~ O~ (SC /tf;>b
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5395 J~~s~57/tJE
BLOCK
ADDITION
4. OWNER
#tchCle/
5. ARCHITECT
(Tel. No.)
tf03 - C; '811
(Name) J /
L/i?~() 117
(NaK,e)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK Fireplace Ll SePtic~Deck Ll Re-roofing Ll Porch Ll
New Construction Ll Alterations Ll Addition Ll Inish Attic Ll /,' ~-siding Ll Finish Basement Ll
Chimney Ll Misc. () rl G rrq <:./f"
8. PROPERlY AREA OR ACRES 9. PRt)PERlY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq- 4-''30
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
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING /
~ ,~~
n1 t~ C,
lYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS Ll SETS
SURVEY
Ll COPIES
PLOT PLAN Ll
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
LQ5O- ctL
_ ~~ ~~ eo CollectiveStreetFee ....................... $
. t> 0 Wl&.V 'be fA. P Art' Sewer Tap ...................................:
i1~ ~ Y~br Pressure Reducer .......................... $
~ 1'Hb-~'nA)~ MeterHom................................... $
'{OO.. WtlA" tfs Water Meter .............~... $
Mechanical Permit Fee ..................... $ J&. ,...,. u"-t> ~ gn"'Fe"e '.:~~
. ~~1#IfJ Vvc;..r- /'"'ewer&waterConnecti nFee ........... $
ter Perm~ ....,1............... $ It. W t T F $
1: rr ~ (::PIP.. f)~ a er ower ee ...........................
Gas Fir I ce e . ~... ...... $. ........., l Water Tap ................................... $
. uilding perm'W,'t n roved. ~ e r (;1 (~tluilder's Deposit ............................ $
Date a Other ......................................... $
?--' W. en
Total Due .............................. $ .... JI. ~
Certificate of Occupancy
Paid L.- "Z- -z.. O~ SO Receipt No. "3 SOB 0
Issued 4{ r n l\ IA
Date . UO f t:t.q By I c...u I1S"
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance a~~ may proceed as requested. This document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State SUlCharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850
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