HomeMy WebLinkAboutBuilding Permit 99-0343
DATE
4/zeo
I
5344- ~NlbNNfAL
CITY Of F I ..vl'( LAKE
INSPECTION NOTICE
. SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
COMMENTS:
t=:t tJ A L-
r
r-
'~/)'j
~ \L:,
XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
/\)I~J
Inspector:
Owner/Contr:
TIME
2.:30
s\
qq- :34-~
o EXC/GRAD/FILLlNG
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
.& 0 FIREPLACE
r"" 1< (<,,0 0 F-
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
QATE R~
4- /13 /.q C)
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.
QCj-31 ~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDREpS /) -J. '.if. "'..I-
_53~Y~ ./<4.
WI3/Qc;
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3, LEGAL DESCRIPTION
1
12. NO, OF STORIES
LOT
BLOCK
PID 'LS"' - fte, ~ -00 l _0
4'J1Z:J-,,~
~~~7tf"
C,;bNTBt.J NlA L- ADD tJ .
(Address) /J _ f rJIf~.1 ~-t .~ '17 . ,.r:- 14, FLOOR AREA APPORTIONMENT USE
5'3 W ~AJ:T-.i'l/ .-fP:;i;l-
(Address) (Tel. No.)
13, TYPE OF CONSTRUCTION
ADDITION
(Name)
~"&4 '13ft ~~-;?7f',(T1~7&'/
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofingK' Porch 0
Re-siding 0 Finish 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 furnished infonnation 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 nd 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 . ial can.revoke th' p nnit for j t ca s Furt.hermore. I hereby agree that the city official or a d, eSi~ee "5!i' enter upon the property to perfO~t~ed ins~tions.
X ~ A , ;;:;"00'7 ~YqY,-_1 ~/J3 /99
license No. ' / ' Da' . /
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
t<-E::.- S A / IC-
I
I
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
L~. 6()
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 "7 '-I . I c;-
Pennit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
1.2~
Sewer & Water Pennij ...................... $
Pressure Reducer .......................... $
Meter Horn ............. ...................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Pennit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7 ~. 0 0
Paid 7 G . c.lD Receipt No, "3. <>b I 0
Date t./-/I,:>/qq BY.(~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinarice a~d may proceed aJequested, This document when
signed by the City Planner constijutes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy. a Certificate of Occupancy must be issued.
This Application BeCXlrnes Your Building Pennit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
- '-- "