HomeMy WebLinkAboutBuilding Permit 99-0143
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS \49.11 ~ e.o.
OWNER
PHONE NO.
[] FOOTING
o FRAMING ~
o NSULATION
FINAL
~~OUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS:
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CONTR.
PERMIT NO.
[] PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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ri' WORK SATISFAC~RY, PROCEED
o CORRECT TI
o CORRECT K, SPECTION BEFORE COVERING
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DATE TIME
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[] I;XC/GRAC/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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Inspector: Owner/Contr:
CALL ~7-42io FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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3. LEGAL DE~IPTION
LOT '1,
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1~T~OZ -99
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DATE RECEIVED
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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
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ADDITION
4. OWNER (Name)
IJ .4f2..1Z-G-W
5. ARCHITECT (Name)
'" \ (Address)
U~I:I~~
(Address)
(Tel. No.)
~-~O
(Tel. No.)
5 ~II /I. .t:.
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction CJ
Fireplace CJ
Alterations 'fI
Septic CJ
Addition CJ
Re-roofing CJ Porch CJ
Re-siding CJ Finish Basement CJ
Deck CJ
Finish Attic CJ
Chimney CJ Misc.
B. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. YelIow
File
City
Applicant
Permit No.
qq-I(/3
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. Pf}9JECT COSTNALUE
'-fI.ci<900 .00
17. COMPLETION DATE
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 ~~~v~ntiOned prope. rty 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
:Uild~=;.wO~ust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to p:::,..:; .hh~ions.
7~ _) License No. , 'P Dete
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE 915BUILDING I
US. /I If!
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TYPE OF CONSTRUCTION: I II III IV (I Yl
Occupancy Group A B E F H I ~
PERMIT VALUATION
/jW. (}O
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
SURVEY
CJ COPIES
PLOT PLAN CJ
S U
~JQSJ
1'"1. lP<5
.-;0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ .=15 ' I':>
Paid /3::;-15" Receipt No. 3L{7l{~
Issued . ~
Date 3 -31f9 By (j 0AJ
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 requJ{ed. This document when
signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
24 hour notice for all inspections 447-9850
Special Conditions K any
City Planner
Date