HomeMy WebLinkAboutBuilding Permit 99-0394
ADDRESS
~
L/-LJ3+ DAKOtA
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
;:15
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING 0 PLUMBING RI
o FRAMING 0 MECHANICAL
o INSULA flON 0 WAfER HOOKUP
)5FINAL /l!.OO':; 0 SEWER HOOKUP
o FOUNDA flON 0 SEPTIC INSTALL
o DEMOLITION 0 PLUMBING FINAL
o FIRE PREV, 0 SITE INSPECTION
COMMENTS: f/:) ~A'A~! \UJ
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o EXCIGRADIFILLlNG
o LKSHOREANETLANO
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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o ~"'TISF"'CTORY. PROCEED
Z::E~T ACTION AND PROCEED
o CORRECT W'bdcgL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Conlr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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DATF I=IFr.FIYI;,Q
tJ--jt/1/ 'l,
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.
Cjq~ 3q4--
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITE':l.:t24 Dclk...:dd .,SL.
1. DATE
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
.$_i. _
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
.5
'Pj;L\O ~
BLOCK
""2-
Ac...IQ.B.<:..
PID ;2"">-(')01"> - 007-Q
I COT ADDN.
4. OWNER ,--(Name)
"':;;~ruJ/<ff"....o'"\
5. ARCHITECT (Name)
.
(Address)
.Lj-i34j)~.:;;,-t. SE.
(Address)
(Tel. No.)
~4D. s-4:::>1
(Tel. No.)
13. TYPE OF CONSTRUCTION
R.e -~oF
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Name)
(Address)
(Ter. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Finish Attic 0
16. PROJECT COSTNALUE
17. COMPLETION DATE
x
Signature
License No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back Side
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
f3cS VIL
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
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PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... <I'
Collective Street Fee ....................... $
Sewer Tap ................................... <11
$
Division 1 2 :3 4
Permit Fee ........................... .... .... $
74- :7'5"-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
\.'2..~
Sewer & Water Permit ...................... $
Pressure Reducer .......................... <I:
Meter Hom ... ................. .... .... ....... <t
Water Meter .................................!I:
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 71~. 0 0
Paid It.. () () Receipt ~1 .~ 5(') <:;4-
Date 4-hQ./ti"l By fJ,v\.----
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning OrdinanJe and may proceed aAequested. 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.
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
C~yPlanner
Date
Special Conditions nany
24 hour notice for all inspections 447-9850