HomeMy WebLinkAboutBuilding Permit 99-0142
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/6-01'1--:1 i4 ~
Llc;&r;-A~A-
I
CONTR.
SCHEDULED
DA TE TIME
OWNER
PHONE NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULA TIO -- 0 SEWER HOOKUP
~ FINAL 0 PLUMBING FINAL
o SITE INSPEC 0 MECH FIN~
COMMENTS: IY~
-[J~ -~_
PERMIT NO.
- - -
99 --/Vd--
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-
-
-
-
-
-
-
-
J! WORK SA TISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~,::~CT WO~F~R REIN:::::E:E COVERING
CAU ..,..... FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
- . - --
CODE REQUIREMENTs ARE FOR YOl/R PERSONAL HE.aTH & SAFETY!
/NSNOTl
-----.._-~>..,"
DATE I'lECE~~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
.Zl9'll
Permit No.
qf-/~c2
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
3. LEGAL DESCRIPTION
~
ADDITION [jt.ti...It:rnJ~
Nr
BLOCK _ 0
~cJc
:3 ?I~<i
{<-ISD
t1s--M.l)o~-o
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height);t) (Width) 30 (Depth);;ls
12. NO. OF STORIES
2. SIT~~DDRESS
L1"~(, /)euc,", 'T
LOT
PID
13. TYPE OF CONSTRUCTION
4. OV;~\~
5. ARCt-MECT
r (Name)
I.... (-Y\Y-.-e-
(Name)
(Address)
( (/:J-) VO) ~T;li;~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re~70 Porch 0
Re-sidi~ Finish Basement 0
SEATS
16. PROJECT COSTNALUE
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. ;25:/000
9. PROPERTY DIMENSIONS
Width /<::)0 Depth~
10. CULVERT SIZE
Yes @
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 ProBll_ 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 Offi~" OKeJl . for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfo~%n~rctions.
/'" (;'" Signature License No. 'Date
FOR ADMINISTRATIVE USE
Front
Beck
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
SURVEY
PLOT PLAN
o COPIES
o
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 (4t 1~
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
1.25
State Surcharge ............................. $
Plumbing Permit Fee ....................... $
Pressure Reducer ..........................~,
Meter Horn ................................... ~
Penalty ....................................... $
Issued
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ...($2..................... $ I ~ ~OO
Paid 'it- c Receipt No. ,~L/;1'-1/
. C~I ())
Date 3-Z - ( f By. ./CLt
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 asi(eq~ested. 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.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850