HomeMy WebLinkAboutBuilding Permit 99-0195
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 5750
OWNER
PHONE NO.
o FOOTING ~
o FRAMING
MSULATION
FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo 0 f'
COMMENTS: -(, t
~bt
~.
\ DATE TIME
SCHEDULED
3-3/-Cf:L
~
Fi.J {.rf G,;
CONTR.
PERMIT NO. gq - t Cj.5
o PLUMBING Rf
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
~
./
- i7~ --~
~
."..,--
/~
\...
~-
--
/
/
hORK S
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
. Owner/Contr:
DATE RECEIVED . CITY OF PRIOR LAKE
BlJlLDING PERMIT,
....- TEMPORARY CERTIFICATE OF
~ ... ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
I. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
Permit No. 31 -Ii S-
3--2LJ-94
12 i
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
5/5D
~u I b,l' Q.. ~ t
G-(
3. LEGAL DESCRIPTION e:)
LOT :;) BLOCK
ADDITION ()al( tftd-9'G C 1-.
4. OWNER (Name)
1 {7(D\;/ l-lelrvTbrlr k
I PID
/?! AC'jdt~
d) -{J&3 - (1 d$'-{l
(Address)
? {NVl--(,
(Address)
(Tel. No.)
'-Ill 7-<0 7~!,
, '-
5. ARCHITECT
(Name)
(Tel. No.)
6. BUILDER (Name)
C VSfol1''1 Lot1CC ff5
(ot1<;f.
7. TYPE OF WORK
(Address) ,...., A
I~OO C/r-fF~
(Tel. No.)
(c/2-t'r3 7 2C; 0
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 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) (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
&00 c::;/
17. COMPLETION DATE
30 cLayS
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 re~ h pm for ju;"t ~J.8' Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X p~,.y~~ . ;:)OIL-j~417 __~-24'-9?
- V Signature License No. Date'
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
:6if:::::::::::::::::=~:~o: fl~~
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
USE OF BUILDINGI.7 /
ILe"c, fJ. I L SPACES ON PLAN
I PERMIT VALUATION
TYPE OF CONSTRUCTION: 'I II III IV (0
Occupancy Group A B E F H I M~ S U
Division 1 D 4 7 4 "2~
Permit Fee ................................... $ .
2 _506 _ ('9 P
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
I ,2'-/
Penalty ..... ......... ............. ............ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
ce Permit ....................... $
com-L... ". ."ding Permn When Ap~;:p... <::l
.~ Date 3-25 71
Certificate of Occupancy
Issued
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
7~ .(30
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.
By
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850