HomeMy WebLinkAboutBuilding Permit 99-0084
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~ l8"G,
OWNER
PHONE NO.
o FOOTING
o FRAMING
.:!)NSULA TION
)! ~INAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: ~e.. ~ t
J()h
SCHEDULED
~ f YK.<.L Tit..
,
CONTR.
PERMIT NO.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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,
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kRK SATISF
o CORRECT ACT AND PROCEED
o CORRECT WOR . REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
DA TE TIME
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o EXC/GRAD/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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
~/7199
I
12-\50
~~~ S/Jrtl~e /r:
3. LEGAL DESCRIPTION I
LOT ""2/...... BLOCK I 1 ~
ADDITION ..,...-- ~ ^' se:r fT\ (....~c;
4. OWIJEf- (N~). j",- (A~~~e~ ('. _ T_
ba t:.V l::J.iC" eJ^SbJ1 3~~rur~
5. ARCHITECT I (Name) , (Address)
PID
fhz,),J
firs -112--otl-3-0
(Tel. No,)
~-5f7;'
(Tel. No,)
6S/,~RJ / het;;: eO J1 ,. f
/j3(fEs?;jted;1t~#~ ~~;-7ff/
{rJ'lI/\. [Ilk.." /
Deck CJ Re-roofing ~ Porch CJ
Finish Attic CJ Re-siding CJ Finish Basement CJ
7, TYPE OF WORK
New Construction CJ
Fi replace CJ
Alterations CJ
Septic CJ
Addition CJ
Chimney CJ Misc.
8, PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Cf/i- ~4-
j
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
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 propelt}l d 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
:uildin 'ial can (evoke tho e It;;J;1~re, I hereby agree :;::Doi'1"P901 d!?ignee may enter upon the property to pe~ "T7d 7o/iL
Signature License No. , Dlte ,
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $_
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... !!"
Sewer Tap ................................... $
$
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
I
A-/R.....
I '
USE OF BUILDING
pr~
Z-sc:t?.. -
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 14.1 ~
Permit Fee ................................... $
City:
Plan Check Fee ............................. $
State Surcharge ............................. !l'
{. L<
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ
PLANS & SPECS CJ
SURVEY CJ
PERCOLATION TESTS CJ
SETS
COPIES
PLOT PLAN
CJ
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 .............................. $
.
Paid f ~'I Receipt No. 34 3q 'Z-
Issued . I <lIar.
- Date 'L ~ By f)..{).~
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 requested. ~iS 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.
Mechanical Permit Fee ..................... $
;:~~;jJlftJ~~ ~1
Certificate of Occupancy
,<'.0...-
24 hour notice for all inspections 447-9850
Special Conditions W any
City Planner
Date