HomeMy WebLinkAboutBuilding Permit 99-0342
DATE TIME
CITY OF PRIOR LAKE 4-'l7-QQ 10 : rro
INSPECTION NOTICE SCHEDULED
ADDRESS , Ll3QO Sh.,r(. ~
OWNER CONTR.
PHONE NO. PERMlrNO. q9- ~2..
o FOOTING o PLUMBING RI o EXC/GRAD/FILLING
o FRAMING o MECHANICAL o LKSHORElWETLAND
~SULATION 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 PREV. o SITE INSPECTION
COMMENTS: ~
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B-a.. +- ~.
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL\OR REINSPECTION BEFORE COVERING
Inspector: ~ <<\ '\ ~ Owner/Contr:
'--'
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
QATE R~
4-/t3/QC;
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
QC1- 34-2-
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
:j~i=~S22::Z:'~ q'tde
3. LEGAL DESCRIPTION
I () BLOCK
SItN 0 PT 4-114- ~ P tJ
~~~~/1j39b~ ~7~Tel4ldP~~
!f.' ARCHITEctf (Na~e) (Address) (Tel. No.)
W3/91
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
LOT
5'
12. NO. OF STORIES
PID ~~ "'2- \S- - 61~ -0
13. TYPE OF CONSTRUCTION
ADDITION
14. FLOOR AREA APPORTIONMENT USE
."Jl~~r3t/~A;?e' ~;;;;;J>fJ
15. NUMBER OF OCCUPANTS OR SEATS
7. TYPE OF WORK
New Construction 0
Fireplace a
Alterations 0
Septic a Deck a
Addition 0 Finish Attic 0
Re-roofinK Porch a
Re-siding 0 Finish Basement 0
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 o. 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
buil in offi .al can revoke thi e it for .ust ause. ljurtherm. ore, I hereby agree that the city official ~ aAl~gnee may enter upon the property to perfony 7~~sP1;tions..
X:7'- .- ~ ,qf)()7K~<j3 ~//~-?/9a
".., License No. Date 7
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
fLEe. 41 e.
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
Z- c-UV. rJV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I " III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
f 4-. I S-
Plan Check Fee ............................. ~.
State Surcharge............................. :to
Penalty ....................................... :t
Plumbing Permit Fee ....................... $
I. 2- r;:
Mechanical Permit Fee ..................... :to
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Permit...................... $
This Application Becomes Your Building Permit When Approved.
By Date
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ......................................... $
Total Due .............................. $
Paid '( ~ . 0 (; Receipt No. 35"0 I 0
Date 4-/f>/qq 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 r~uested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certfficate of Occupancy must be issued.
7~.OO
Gas Fireplace Permit ....................... $
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850