HomeMy WebLinkAboutBuilding Permit #99-0146
( OF PRIOR LAKE
INSPECTION NOTICE'
ADDRESS J L./-I2- '3
OWNER
PHONE NO.
o FOOTING
o FRAMING
~'NSULATION
NAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
POMMENTS: Rc S..-d.~~
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i "-s-l-~.J~ j.
DATE TIME
SCHEDULED
5-5- '1'1
<1~~
~GAtvotcL ~.
CONTR.
PERMIT NO.
qq - 14-b
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SewER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILL/NG
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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o WORK SATISFACTORY, PROCEED
~CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
~~L
Owner/Contr:
CAll 447-423!lfOR THE NEXT INSPECTION 24 HOURS IN AOVA!!CE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE RECEIVED
.
j !H)
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq'-6I'-1~
I tilRECnONS 1'30, A.TE~'tj p' f\;.
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE AOORI;SS .,/ / /J / /J. )~
/<.J/tf3 L' (Jc1t7 r //)I:)<2..n LJr4!e ,/J.G.
3. LEGAL DESCRIPTION
PID c0) -;)J y- ~ J-/"-D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
LOT
BLOCK ~
~~J:1 5YtLAddP1
I
{Address) /) _ J _ /(Tel'~J 'J'A
I ij/ ~ Ce...tM/ u.J C)t!lrl "Y;-P - tllJI'n
(Address) (Tel. No.)
12. NO. OF STORIES
II
~l
ADDITION Xi J-l ol
4. OWN~ (Name)
I J/'tI,Ih/J1er.
5. ARCHITECT (Name)
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
M! ::eM7J 1e6~'
05:;" d/U:sJ.
-<ldR -tJg'l~
7. TYPE OF WORK
New Construction a
Fireplace 0
Alterations a
Septic 0
Addition a
Deck 0
Finish Attic a
Re-r~g 0 Porch 0
Re-sidin~ Finish Basement a
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
)i.lX>MPLETION 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 abov~me . ned 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
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X ~A... --'-~, I ~?C} .:::> 7
- ~ . License No. I te
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
a ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ~ fll/I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS a
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .... .... .......... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
74.15'
f.)~
State Surcharge ............................. $
Penalty ....................................... $
Gas Fireplace Permit ...................... $
ThiS~PPIi Becomrt- lr Buildi
By; .
~:r"j .r
Certificate of Occupancy .'
Pressure Reducer .......................... $
Meter Hom ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Total DU~......................... $ ~ ..ff)
Paid 7~. Receipt No. 3L/7:l)
Date .3-q 49 By 0/4 AJ
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 requ~ed. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850