HomeMy WebLinkAboutBuilding Permit #99-0316
ADDRESS
OWNER
3559
DATE TIME
SCHEDULED :zjLs,/:l:l 2 : 3 ()
ISLAND Vl6ttJ C!..-/e..
CITY OF PRI9R LAKE
INSP~CTION NOTICE
CONTR.
PHONE NO.
PERMIT NO.
99-3/0
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION I.?')) 0 SEWER HOOKUP
/l( FINAL !l.()OF W 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
---
o w6'RK SATISFACTORY, PROCEED
I!l"'CORRECT ACTION AND PROCEED
o CORRECT WOR! CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,.ff1:tJ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
QATE RECE!YEQ . -CITY OF PRIOR LAKE
( / ~ BUILDING PERMIT,
~ t1 q.q TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- 3( 0
1. DATE
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
35SCf
3. LEGAL DESCRIPTION
I<;LAND \/l~
-<S.. I C\ I ~ <\.
~ ~ r<. C--L-L; f\! W
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO, OF STORIES
PID 2.5 - \ 8'9- ODS.
Il:T ADDN
o
LOT
BLOCK
'SOr<..LA E:N 9- tfOFFMAN
ADDITION
13. TYPE OF CONSTRUCTION
4. OJ./NER (Na~e)
, '\ \..-.~......~ L ~ r ~~~\,~'"
5. ARCHITECT (Name)
(Address)
~~
(Address)
(Tel. No.)
"'~- ~G~\
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
$
7. TYPE OF WORK
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Fireplace a
Alterations a
SeptiC a
Addition a
Deck a
Finish Attic a
. r
Re-roofing at Porch a
Re-siding a I Finish Basement a
SEATS
16. PROJECT COSTNALUE
New Construction a
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 ~that all construction will conform to all existing state and local laws and will proceed in accordance with submitted Pia. .ns. I am aware that the
buil~g ~cial can revoke this e 't ~ cause. Fu~ermo~hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X c:\. ~ 1&-40. ~ "" ,'" \:.a..~ ~ ~ ~ " "'\. I 0... t ~ C\.
Signature License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
a
o ENERGY DATA
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
~tS
AIR-
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS a
SURVEY 0
SETS
COPIES
-z..... ~ - (TU
PLOT PLAN
a
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
,Lh12>
Plan Check Fee ............................. $
/.?..S
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7ft;. 00
Paid 7 ~ .0 0 Receipt No. ~ 4-8 Cj' I
Date 4-/7/qq By ~au
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning O;din~nce and may proceed as re~sted. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
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 for all inspections 447-9850