HomeMy WebLinkAboutBuilding Permit 99-0344
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
4Eo
OWNER
PHONE NO.
o FOOTING
o FRAMING
~SULATION
INAL
'" 0 FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: l2a.r-
~
~~+- ~~\
DATE TIME
SCHEDULED
4-2.2-t:tQ
4i
9oJu1a
r::r
CONTR.
PERMIT NO.
qq." 3'+4
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
1=NL.-
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
......lL.
/
-X'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
.-r t
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE RECEIVED.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
4113/q~
Permit No.
qq -344-
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
LI?"3tj ~a: sf
1. DATE
i./1/3jqQ
82-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
S~. ro
12. NO. OF STORIES
LOT
BLOCK
PID 2...5 -0 c> I - 0 (q '-f - 0
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
~d tI J::fJr.t./J ri~U"
5. ARCHITECT
(Name)
(Address)
i../?3 tJ 7Jabfa Sf
(Address)
(Tel. No.)
(i4I.;1)'141-~6l
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Same
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
~
Re-roofing Porch 0
Re-siding 0 Inish Basement 0
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
:uilding 0 ieial can ;;(~: just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfo~nt3/n:;9tions.
Signature License No. D te
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
ICES ~/re..
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
'2.. <::ciO , au
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
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
Ir..{. res-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
, . '2... S-
Sewer & Water Permit ...................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Issued
Water Tap ................................... $
Builder's Deposit............................ $
Other ......................................... $
Total Due.............................. $
Paid -J{;, .00 Receipt No. _ :;3~D I I
Date 4/,'S/qCJ By -11~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdina~ce and may proceed as req{.ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cert~icate of Occupancy must be issued.
7~.OO
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850