HomeMy WebLinkAboutBuilding Permit #99-0286
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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.4.1.
ADDRESS
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QUr AI (!AI ~ I .
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FRAMING
o INSULATION
o FINAL
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 LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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COMMENTS:
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOP tEINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
III 1-
Permit No.
CJ9- 2f~
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
L/3 t?~ QUI N~I./ s-ne6t:..-'1
1. DATE
4/1/q9
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIp'TION
q 'f /0
:5tJ tV FISH
BLOCK
PID
25~Ot./.-3' ()Of,~ 0
12. NO. OF STORIES
LOT
ADDITION
l3~
,
13. TYPE OF CONSTRUCTION
4J>~ER I I A (Nam,~
/~ Kf.4J./~
5. ARCHITECT (Name)
(Address)
~ fJ.... ..'-^ cy .JT se
(Address)
(Tel. No.)
(iOJ W7-&~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
J,4n f-
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
"
Re-roofing~ Porch 0
Re-siding 0 ' ~inish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
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
:Uild~~ JLOk~ P~([llit for just cause. Furthermore. I hereby agree that the city officia~iZnee may enter upon the property to peq,: n7~11spections.
.....7~gnature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
8ack
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
Je6.5
I
Aj~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2500.00
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 7tf. 75
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
/. Z='
$
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit...................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid "16 . 00 Receipt No.
Date '//7/1' 1 By .::f1ettp
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce and may proceed as relf'sted. This document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
7(0. 0 0
3~~"e
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
-
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850