HomeMy WebLinkAboutBuilding Permit 99-0393
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS .539 I
OWNER
PHONE NO.
o FOOTING
o FRAMING If
~NSULATION
FINAL
o FOUNDA liON
o DEMOLITION
o FIRE PREVo
COMMFNTS:
1/
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V
DATE TIME
SCHEDULED
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.A.-T"
CANbY LcVG <Irz.
CONTR.
PERMIT NO. ~~ - "3R3
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SeWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHORENYETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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.I
('bAt
rl
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~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT10N BEFORE COVERING
Inspector:('\l~
Owner/Contr:
CALJ_ 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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QAII= ~:u=r.I=I"I=l')
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicam
Permit No.
qq - 3Cr~)
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
..j-:?Cf/ CavVf(JU C-~tJP, II/'Cf: )
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT , 0 BLOCK
ADDITIOrl AI<( F sIn ~
4. OWNER (Na"l\')
C:arH- kor-l-'~o~
5. ARCHITECT (Name)
12. NO. OF STORIES
2-
2ND ADD/\J.
PID
2.6'"-0.0 - 015"-0
(Address)
.s- ?) q I C.(:t wOl! lCl)~
(Address)
(Tei. No.)
+n>./ L/'IO--l.o-;il\J'D
(Tel. No.)
13. TYPE OF CONSTRUCTION
~ ~eov~
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
LIt? ?-.590l>
Ro(/.Q rJ Ul W S-:S-.7 7 Y
Re!fc)ofing,. Porch CJ
Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished 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
bUilding~cial cn ~evoke this ermit r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~\ A~H^- #:.3/ro f.j-/fI-tJo/
- t. Signature -- License No. Dale
Fireplace CJ
Alterations 0
Septic a
Addition 0
w-"flt~-<y~-
Deck 0
Finish Attic a
SEATP
J)tfcoT.A.-L-
7. TYPE OF WORK
/'Ir/o
16. PROJECT cOSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Fron!
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 _
1i!J:;,;, MIL-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
?_nru.<./O
PLOT PLAN
o
TYPE OF CONSTRUCTION: f II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ...................................:t
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
144.50
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.......................... ............. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
2..'5""0
Sewer & Water Permit ...................... $
Gas Fireplace Penni! ....................... $
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other .......................... .... ........... $
This Application Becomes Your Building Permit When Approved.
By Date
/'52..00
35051
Date 4-/' q I ",q By-{tv----
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce a~d may proceed as r~uested. 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.
Total Due .............................. $
Paid 14:11- . cfD Receipt No.
Certificate of Occupancy
Issued
CilyPlanner
Date
Spac~1 Conditions if any
24 hour notice for all inspections 447.9850