HomeMy WebLinkAboutBuilding Permit 99-0378
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
sp"kJ
TIME
11.r.
.
ADDRESS
4LI::>~
DAKo/,-!
OWNER
CONTR.
PHONE NO.
PERMIT NO.
SQ"3,?E
o FOOTING
o FRAMING
o INSULATION
W1:INAL ~tJ.F
~i=OUNDATION
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
o EXC/GRAD/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS;
/I
rod-
. .
f.:-o/L:S tp1-,
',D~
I
. ,.
Co !Vl"t .p.LtJ-r
~ - .:~ ----....
~ "'J
/rcA~.. '.~i~~J)
If " ~ .....". / )
.~ ~/
-.....:::... -- ---
./
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~. I . ~. , , Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
QATE RE<&JY.EQ CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2, Pink
3, Yellow
File
City
Applicant
Permit No. q Cj " ?:;J8
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.tITE ADDRESS ~ I. j _
~.t/5"3 -/ /A-/Cr77J -S T 5. E.
1. DATE
1-1"- 19
IZ--::L
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
I (
Pt<.J OR-
12, NO. OF STORIES
LOT
BLOCK
'3
Ae..e.5S l ~ AuDN "-
(Address) I' J'
'1rt53./)/li;?!R <iT
(Address)
PID 25-c::x:>f3.... OIt1- 0
13. TYPE OF CONSTRUCTION
ADDITION
4. ?WNER, (Name) a
/ /u?nt~ /U U'~"7Z
5. ARCHITECT (Name)
(Tel. No.)
~q 7 -1./il?Z)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6: BUILDER
(Name)
(Address)
(Tel. No.)
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-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify t t I have fumished information on this application which is to the best of my knowiedge true and correct. I also certify that I am the owner or authorized agent for
the above me oned prope nd that all struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin ici can revoke it f use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform. nJ8ded inspections.
X 9'-/?~yY
License No. Date
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
e.t~ MY2-
;
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
L ~, c-t::>
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~~~~i~~..~...~...~..~... $ ,4-. '15"
Plan Check Fee ............................. $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
State Surcharge ............................. $
Penalty ....................................... $
l. '"2.- s;-
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Total Due .............................. $
Paid t(.. CJ1) Receipt No. ~'S04-a
Issued
Date et' / lG I q q By.{.hL---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina~ce and may proceed as'~ested. This document when
signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
1(,.00
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850