HomeMy WebLinkAboutBuilding Permit 99-0188
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
L{ ->0
ft-T
ADDRESS
l~(55
Cv-e.-~ 1- A-vt _ Nt S.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
90r - 18'Y
o FOOTING
o FRAMING
~NSULATIO~ Cr_
~ ~FINAL f.4:'~
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHORENVETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
I~ ~ u-f"-f-.\
, '4? ~ .
....15
/
"R5WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F.l\~EINSPECTION BEFORE COVERING
Inspector: ~j ~\ I Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
DATE RECEIVED
.,i.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION P~RMIT
1. DAT? I
3/( '7 CJq
( , I 'I
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 S S
3. LEGAL DESCRIPTION
CreST
iAJ ~~C~e {r~
I
LOT
ADDITIOtJ Zl-f, d ~.
4. OWNER (Name)
13ev e,,\ "'\ ck t....cl It-> l,-K
5. ARCHITECT (Name)
All€..
rslE-
PID
z ':;'1Lt-COZ-)
(Address) (Tel. No.) ~ { 2
\ ~?SS cresT "'\J~tle. yo..3- 03</0
(Address) (Tel. No.)
L0fsTvrrJ
(Address) 1/ . '}JCJtjLJ1el. No.)
{1J,UjI7vui{{ v'2-
'J 0 ( 1Iv-Jc.1 't ~~ ,..) D ~t/ I -0"3 0 L(
Septic 0 Deck 0
Addition 0 Finish Attic 0
6. BUILDER
(Name)
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Fl.
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.$df38
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
I hereby certify that I have furnished 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 a~ware that the -'l
building official can revoke this P~it for jUs~. Ol" Fooh,=re, I h..." ,,~ ." tho 00, ,,"'" " , "".- ~, """",00 ... ''''''''''' to _m fi9:. ' ~~, tP
X ~( ) 20 IS ~5lP~ 03 i '1'Q
S alure - . ~ License No. te .
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION r
USE OF BUILDING fZ-E::-s 4 I ;L
, I'
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
-2 "1C){j
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 "i' A '1:e-
Permit Fee ................................... $ ~~_
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
r.2-5
Date
Special Conditions ff any
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
This Builder's Deposit ............................ $
Other .... .fiit........ ............................ $
Total ue .............................. $ -, &. --
Paid -?, . Receipt No. ~'\
Issued
Date . r 1 (.,--, By f.-.-.t .
t - ,
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 requested. 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.
City Planner
24 hour notice for all inspections 447-9850