HomeMy WebLinkAboutBuilding Permit 99-0106
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
J-10-Q1 -4'
ADDRESS -L~5lfJl ~
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'1Q -/O/,
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
SEPTIC INSTALL
DUMBING FINAL
o SI INSPECTION
o EXC/GRAD/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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(WORK SATISFA~Y' ROCEED
o CORRECT ACTI P CEED
o CORRECT WORK, l ~ FOR E/NSPECTlON BEFORE COVERING
Inspector: Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CALt 447-42 0 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE~
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CITY OF PRIOR LAKE
BUILDING PERMIT,
FEB 11 &EMPORARV CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
?f;~h'l5-: White
2. Pink
1I~,.a? 3. Yellow
File
City
Applicant
L DATE
Permit No. QCj-{)!00
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
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BLOCK 3
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3. LEGAL DESCRIPTION
LOT ct
ADDITION f3rno Its V ~ II e...
4,~. R . (Name~.
,~ i?~~
5, ARCHITECT (Name)
PID DllJ-()/h- Od..-q-D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address) ......~ ,Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
/631/8" tAC>a- -d'E. W?-6fi1/
(Address) (Tel. No.)
6. BUILDER (Name) (Addre~ss) . 1 (Tel. No.)
/7 3 Ii g '.At!J1'7 ;).../- (, (,;>8
('/~/k/r~./~ if/J('-'71 )'rl,p~ -T!~~~
"1. ~P~ ~ ';;;R;;:;-. FiMplace 0 Septic 0 DM:k 0 Rlt-foofin Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 ish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
Yes No
10. CULVERT SIZE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTN~
5'5:51#~
17. COMPLETION DATE
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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 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
building official can revoke this permit f~r just ~se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
.. X ?:;_~L t!/~ ,2/?q /()-9- ~J>'
-- / Signature License No. Date
'c_ _
.. -
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~i~~~~~~...1...~...~..~... $ 14.1~
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
J.J.5'
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $
Paid D2 -/7-11 Receipt No. 347 13
Issued . ~J-I7J;fl ~ r '
DatEO<{ 7'7 B" 4
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and ma s re~!'1J Ejd., ~~~~.,'., ',urn.en,. t. When.,: I
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, . . . ,r:1Cy#/t!~,i~~.! _, ~ ..
City Planner Date Special Conditions ff any
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Dare
~ertificate of Occupancy
24 hour notice for all inspections 447-9850
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