HomeMy WebLinkAboutBuilding Permit 99-0237
DATE TIME
CITY OF PRIOR LAKE 4-1lo -QCf
INSPECTION NOTICE 13CHEDULED 1{):30
ADDRESS 152..5lo Ed.5ewcv\-~ Gr
OWNER CONTR.
PHONE NO. PERMIT NO. q'f - l37
o FOOTING o PLUMBING RI o EXC/GRAD/FILLlNG
o FRAMING o MECHANICAL o LKSHORE/WETLAND
~SULATION 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 PRE o SITE INSPECTION
EED
R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE RECEIVED
CITY OF PRIOR lAKE
.'
BUilDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
It LjIQL/
MAR 3 o.
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
1. DATE
r
C:r
Ave. lsb
PlDdS-osl-- (01-0
3. LEGAL DESC~ION
LOT y~ BLOCK
ADDITION Jv1.c . t 1S(;)I\
4. OWNER (Name)
Luc
(Name)
IsVLl1f(
(Address)
\(e r)J
(Tel. No.) 44?- ?Cli'
i-
(Tel. No.)
5. ARCHITECT
I. White File
2. Pink City
3. Yellow Applicant
Cf1~L37
Permit NO~:J.. gq
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES 1
13. TYPE
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.) WI -'Ba..3~ 15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SLv
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
SEATS
16. PROJECT COSTNALUE
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 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 0 icial can revoke this pe it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 1+-4~8q 3-~S-qCf
Signature License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $
Paid / _ 60 Receipt No.
Date '3 ;?::LYC{c( By
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 his 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.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING 0.s A ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 I Lf . 1 c::;-
Permit Fee ................................... $ <
, .1.~
City:
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit.. ........ ............ $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ~ any
24 hour notice lor all inspections 447-9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS c::J
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o