HomeMy WebLinkAboutBuilding Permit 99-0120
.. DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 2 -2.lI-<jq 4-r
ADDRESS 5587 ~t....n:>nri S-,-
OWNER CONTR.
PHONE NO. PERMIT NO. 'tq -I z.o
o FOOTING o PLUMBING RI o EXC/GRAD/FILLING
o FRAMING o MECHANICAL o LKSHORE~ETLAND
~SULATION o WATER HOOKUP o COMPLAINT
FINAL o SEWER HOOKUP o SEPTIC FINAL
o FOUNDATION o SEPTIC INSTALL o FIREPLACE
o DEMOLITION o PLUMBING FINAL 0
o FIRE PREVo o SITE INSPECTION
COMMENTS: t<e. ~.{.
::>n()l.u
Cov'~((9
Uok
Af~<:
Co ~'fU
~
/
/
, WORK SATISFACTORY, PROCEED
o CORRECT ACTI NO PROCEED
o CORRECT WOR t, CA OR RE SPECTION BEFORE COVERING
I
\
'-
----
/' \~
Clest \=. ~ I
/" }
----- -----
Inspector: Owner/Contr:
CALL 447-4*30 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ~ "IS 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)
2. SITE ADDRESS
f;f:)<{-'l
1. DA-E
d (j~/qq
rUD
flT 1- ~ ~tlf'Z-o
- -
3. LEGAL DESCRIPTION
LOT ~
(W^ (11nnrL ,,<\f
~ PID
5T~ Aoo
ADDITION
. BLOCK
~AW.pOl~
4. OWNER (Name)
7T 11 rv-\-
5. ARCHITECT (Name)
I J, (" (Address)
~ V-r-<V\hf.~'1
(Ad_~)
LJ40-((;~) II
(Tel. No.)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qc' \'W
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name)
&e.USer
(Address)
firoh'ltq .YoJ5jJ ~~~o+i\. Lf);J,,-j<NJ......
Fireplace 0 J Septic 0 Deck 0 Re-roofing~ Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
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
:uilding 0 ic' I can re ok this..perm~mo;,e, I hereby agree that the city official or a designee may enter upon the property to P~7
Signature License No. ; Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
;
(le;. ~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Gas Fireplace P
This Applicatio
By
Certificate of Occupancy
City Planner
FOR ADMINISTRATIVE USE
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION Z....,(JU. - PLOT PLAN 0
R S U
-'4-15
City:
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1 Co- - Receipt No. ~ 77 - (
Issued . if..,? ~./ A n /'\i.- -, .
Date l~ By /VllH'
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning drdinance a~d may proceed as requ~~ed. This 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.
I. 7.<)
Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ............................. ...... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
1 (LJ .
24 hour notice for all inspections 447-9850
Special Conditions W any