HomeMy WebLinkAboutBuilding Permit 99-0163
DATE TIME
. CITY OF PRIOR LAKE 'i-7-tfI Ar
INSPECTION NOTICE SCHEDULED
ADDRESS 155"34 07- :LJ
OWNER CONTR.
PHONE NO. PERMIT NO. Cjq- LCoS
o FOOTING o PLUMBING RI o EXC/GRAD/FILLlNG
o FRAMING o MECHANICAL o LKSHOREnNETLAND
USULATION A; 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 ~ ~TE INSPECTION
COMMENTS:
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oj
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EINSPECTION BEFORE COVERING
Inspector:
. Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN ADVANCE..
DATE RECEIVED
.ll~
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 -163
- 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
I ~~- 3if
OM 1;/.r1+
3. LEGAL DESCRIPTION
LOT II BLOCK
7h~ Tre6
ADDITION
1. DATE
;~ /11 I c; 9
RI
7lfHi i-
f
PID
;(S--d07-o/l-o
4. OWNER (Name) (Address)
1?(V~ -+-l ':'-rJl'I/ (YA(l-& ctLJ ';,~~-'J 4- ~mc.~ ~.
5. ARCHITECT (Name) (Address)
6. BUILDER
(Name)
(Tel. No.)
~~ge:J-j'
(Tel. No.)
(Address)
f},8.C.
7. TYPE OF WORK
New Construction 0
0';, n) (1.~L~o.) r
Vlf...{l /07-~9rr
J~:J-3,? N r Ct:J d71J iJVJ;-~. L? VI1..obJLJ'///;
Fireplace 0 Septic 0 Deck 0 Re-roofing,ti{ Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re.siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Widt~ (Depth) 4-~
12. NO. OF STORIES
~
13. TYPE OF CONSTRUCTION
tr]l; ~,-1/117 r
14. FLOOR AREA AP~TIONMENT USE
..3 't-()(J r .
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. jfOJECT COSTNALUE
~717f3~'f
17. COM"'LETION 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 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 for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
Signature
License No.
Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING 6.5 d / K
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Division 1 2 3 4
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
'7L/-7S
City:
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penally....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0
PLANS & SPECS 0
PERCOLATION TESTS 0
SETS
SURVEY 0
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
j.J.s
Pressure Reducer .......................... $
Meter Horn ............................ ....... $
Water Meter......",...,.",....."......,.. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
t
.as F eplace perTT)l, 't, ',........., .., """.'",","',1,",'" $
.'" ," ; I , ""'" I
. APp~e~~i~9 P~~i: When Approved.
y - )t, ~, ,.
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid /0 - 00 Receipt No. :5 if 71.01(
~ ~j
This is to certify that the request in the above application and accompanying documents is in accordance with the c~:~oni! ~r~~a:c~~ may pr::ed as req~~ed. This document when
signed by the Cify Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Cert~icate of Occupancy must be issued.
Certificate of Occupancy
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
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