HomeMy WebLinkAboutBuilding Permit 99-0031
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED '7 - C. ~ c::r:t to= SO
ADDRESS 4rw ~~ PiHd.
OWNER CONTR.
PHONE NO. PERMIT NO. qq- 3/
o FOOTING
o FRAMING r@
o SULATION
FINAL
~~UNDATIO
o DEMOLITION
o FIRE PREV,
COMMENTS:
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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,,"WORK SATISFACTORY, PROCEED
o CORRECT ACTIO~D PROCEED
o CORRECT ~ L FOR REINSPECTION BEFORE COVERING
Inspector: k i Owner/Contr:
o EXC/GRAD/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
,..;v't-- () otJ![ I ,/ "2)-~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
,,1~.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print 'Or Type and sign at bottom)
1, DATE
1-15 - 9'9
j/Jr
2,SITEAL;(/Q() /1 rouGh/)tr1 BILI/)
3, LEGAL DESCRIPTION
LOT 7 BLOCK I. PID;;' 'Itb -007-0
ADDITION (!~/7/U4Lfu 1JJi; :1 -.-A-'/i ii ~ /
4. OWNER [) /(Na'me)
\< e. V I V\ feie r-.$' ml)
5, ARCHITECT (Name)
L\ 0 q ()
~ddress) t
1'\ '("0 V .shAWl
(Address)
(rei, No,)
l.fL/7 -S 00 7
(Tel. No,)
8lul)
6SeL\E~ QhO ~~;e) y \ ~ () G X ()T~e~s~ r is \ ~) D ~jI3?~8 6 l{ b
7, TYPE OF WORK 5 Fireplace CJ Septic CJ Deck CJ Re-roofing a.- Porch CJ
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney CJ Mise,
8, PROPERTY AREA OR ACRES
Sq.Ft.
9, PROPERTY DIMENSIONS
10. CULVERT SIZE
Width Depth
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. (;1- ~ 0.3)
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CON~T~TION
,r-Clau 1-
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJE~C~1Lt-
( ,
17. 9.qMPLETION DArE
5" 15- 99
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 prope nd t all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:u~I??~revoke e~,. for just cause. Furthermore. I hereby agree that the cltyJ~bU (Jsignee may enter upon the property to perfoi ~e.iS~9
/ 17 ( Signature License No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 'It,. Db
Certificate of Occupancy J. ). 11/\
Paid 1 '" . f) 0 Receipt No. .J. L/~ 'rU
Issued I, ,-lilh
Date J !...l.!iLv 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 r
signed by the City Planner constitutes a <o.....w..ary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 4: . f)lJO . ()u
USE OF BUILDIN+/IJ./L
TYPE OF CONSTRUCTION: I II III IV V
City:
Occupancy Group A B E F H IRS U
Division , 2 3 4
Permit Fee ................................... $
7L/ 73
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
/.l.r
Subtotal............................... $
1L (}(..\
This Application Becomes Your Building Permit When Approved.
By
Date
City Planner
Date
Special Condhions n any
24 hour notice for all inspections 447-4230
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
CJ COPIES
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