HomeMy WebLinkAboutBuilding Permit 99-0083
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. CITYbF PRIOR LAKE
INSPECTION NOTICE
DATE "0
SCHEDULED
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ADDRESS I b 1".3
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FRAMING
~NSULATION IJr
FINAL ,.
FOUNDATION
o DEMOLITION
o FIRE PREV.
COMMENTS: ~ ~
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o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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,/ WORK SATISFACTORY, PROCEED
o CORRECT ACTI075D PROCEED
o CORRECT WORK Cf4 NSPECTION BEFORE COVERING
Inspector: \. Owner/Contr:
CALL 44~230 FdR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQYNTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE REQfJYf.Q 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
/6/ b:5 FI'/ / h1 OY'-€ Ave
3. LEGAL DESCRIPTION ..(
LOT ~ BLOCK q-
ADDITION - ~~0 \J \ l-~ rt~ l-L- S>
4. OWNER (Name) (Address)
.....BJ.Ch4..d Bv.n<..~OVJ, Ibll '?
5. ARCHITECT/ (Name)
}j A
6. BUILDER (Name) (Address) (Tel. No.)
/r1<1..yit-lI" l~vjlJ {lot:! Co~Ty.,d"YJ:Ch {, (f/'J) 707 ~ '51
I '{). ~ s 3 N,' c 01/ df A v., ~() gUY".I V,'II--e /VI., 5'$337
7. TYPE OF WORK Fireplace D Septic D Deck D Re-roofin9l'l\. Porch D
New Construction D Alterations D Addition D Finish Attic D Re-siding D Finish Basement D
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,
SE.
PJ--J 011 L t /C-e
1\1"
PID II Cj - \ B 1- 050 - 0
(~~ A.h '^
(Address)
(Tel. No.) 6. /2..
1=.'11 mo~ Avp '1lf7 tJ)'.t..
(Tel. No.)
Chimney D Misc.
8. PROPERTY AREA OR ACRES
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
Sq.Ft.
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. q9 - w f3 3>
l<:- ~UILDING INFORMATION
11. SIZ~ OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
f). s:r evy .:=,01.1
13. TYPE OF CONSTRUCTION
W DCOJ P"',UI-< Aff.; JvJ;t.'l(
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
'"7 t?~O
17. COMPLnlON DATE
.l. - 10 - 7'1
I hereby certify that I have fumished infonnation 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 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin~1 can revoke. t t~his peM~st 9lt~e. Furthennore. I hereby agree tha the city official or a designee may enter upon the property to perfonn need~ i~?1tions.
X '" ~ -J/..JL.t...-.- 0 4/ t{ 80 :J - 6 - '7'7
( / Signature - License No. Date
~
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
J
USE OF BUILDING _tZE: ~ I1Jl<-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~OO.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Pennit Fee ................................... $
14.,6'
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Pennit Fee ....................... $
l. Z. f?
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
GaSFir~eit ... ~~... -..$ t I
This Ap cation . . g Pennit Wh~frM'
By Date
,
Certificate of Occupancy
MATERIAL FILED WITH APPLICATION
SOIL TESTS D ENERGY DATA D
PILING LOGS D PERCOLATION TESTS D
PLANS & SPECS D
SURVEY D
PLOT PLAN D
SETS
COPIES
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
~.
Paid 1 ~ - ) Receipt No.s4 ~ '1.. {
Date '- f ~ '1 c, By fL.IJ \rl-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinanbe and may proceed as requested. 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.
Issued
Crty Planner
Date
Special Conditions rt any
24 hour notice for all inspections 447-9850