HomeMy WebLinkAboutBuilding Permit #99-0305
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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to:~
ADDRESS GLleq
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
Cjq -.1)5
o FOOTING
o FRAMING
o INSULATION ^
~INAL f'\
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: ~ ~
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXCIGRADIFILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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P WORK SATISFACTORY. PROCEED
~ORRECT AC A D PROCEED
o CORRECT RK FO EINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CAL 447-423(1 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE~ENTS ARE FOR YOUR PERSONAL HEALm & SAFETY!
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bOllom)
2. SITE ADDRESS
SL4 RCI
QATE R~CEIVEQ' CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
~-d1-q9
Bro()~ (y. S~ ~
3
.q-"T'ct
({\
3. LEGAL DESCRIPTION
LOT \ <0 BLOCK
ADDITION :BeoOJC.->V L u-ff: ttt..,L. L- S
PID 25-02..\ - 030 - 0
ADON,
4. OWNjl\ (Na~e), '\ J
elaN w<.n7f'_
5. ARCHITECT I (Name)
(Address)
su..-rn f .
(Address)
4l/(7:.N~9 c;-
(Tel. No.)
6'L~\)fL 6D6t CON5f. cj~f:je() {L)./2<:>'/z,5+ (Tel~iu'S-4Qt5J
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 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. YelIow
File
City
Applicant
Permit No.
qq- 30:;-
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 ;:'\
'-15'OO,Dv
17. COMPLETION DATE
4- I (o-q'i
I hereby certify that I have fU~' hed 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 prope a that a construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
builqirl!rl>fficial can revoke th e it for st cause. Furthermore, I hereby agree that the city off'1ial or ~ejignee may enter upon the property to perform needed ins~
X ( J:1.JU5n 'N/) ( tJ K (fJ ~ .~ ,-a..9 "Lf-
~ Signat - License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
'eES
f></e-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2- c;-v-o . c.ru
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
City:
Permit Fee ................................... $
'74-- 15"
Plan Check Fee ............................. $
1.2S-
State Surcharge ............................. $
Penalfy ....................................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $ IV,'O 0
Paid /((1' 0 0 ReceiP;r;t No 34-1 Sl7
Issued ~
Date 4'/~ /'1 i By '1_
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning O/dina~ce and may proceed as quested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 0 Occupancy must be issued.
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
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850