HomeMy WebLinkAboutBuilding Permit 99-0133
r;('r( TIME
CITY OF PRIOR LAKE if
INSPECTION NOTICE SCHEDULED
ADDRESS (04) ~N.SO+a . <;T
OWNER CONTR.
PHONE NO. PERMIT NO. '1't-tIII /33
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING ~ 0 WATER HOOKUP 0 FIREPLACE RI
~NSULA TIO 0 SEWER HOOKUP 0 FIREPLACE FINAL
FINAL 0 PLUMBING FINAL 0 GAS LINE AIR TST
SITE INSPECTI N 0 MECH FINAL 0
COMMENTS: ~ ~ .,.--- '\
lk~ _~/ eLK I
.~ ~ ~?{/ ~/
------
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OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
---~-~"-_._._-
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Ot0._/?.......
Permit No. (( ,2.~
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADORES~O Lm M/J /'
...J l TV /(/ ( I/V tv r:'SO"':-/!-
BLOCK ~
CoSi~S
1. DATE
~?/
) ~;16..y'1
Sb (<..1-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
l0
12. NO. OF STORIES
LOT
'PID
M'DN
" c::;.. 00 4f"0 'Z..4-o
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER J
J11L5
5. ARCHITECT
(Name) J '/
t.u //11 r--c
(Name)
(Address)
2JN~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER (Name) (Address)
I!o1#V J ,..,/_~ . 43" 5
/ ~q Il?:.~~~r P rl/ 0/'1
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
pl1iK"r prel. NOS T 5 e ~
L~ h~ , '1t!7-2-~~O
Re-roofin~ Porch 0
Re-siding 0 I Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
17. COMPLETION DATE
Sq.FI.
Width
Depth
Yes
No
I hereby certify that I have fumished information 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 co ction' 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 ~ermit for jU. use. ermore, I hereby agree that the city official or a ;!..~si~~e ma~nter upon the property to perwrm nl\edJld .J,P:ol>"ns.
X /-L V '-- ~. ;)..6/&j "f I~f::> ~-c;7iO.r7
Signature ~ License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
BUILDING DEPARTMENT VALUATION
'-
~~L
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
USE OF BUILDING -tL.E:<7
-2500 -
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 ( 4-. 1 \'
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
\.'l..S
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee .................. .. $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Certificate of Occupancy
-, '- --
Total Due .(;j.......................... $ . '
Paid k. e Receipt No. dfC/73L/
Date ;21x/t[y By CJ/:1L.{ )
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoning' Ordin~nce and may proceed as re<fuesled. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~-~ft
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
This Appli
By
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850