HomeMy WebLinkAboutBuilding Permit 99-0400
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LVONS Av6.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
10ClICJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNCA liON
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
COMMENTS: F II.! kl.---
TIME
3',00
QCj-400
o EXCfGRADfFILLING
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
'A- 0 FIREPLACE
rr- 'J'..-~'.~~
X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~A~OR REINSPECTION BEFORE COVERING
Inspector: . '\ '\ \\. . Owner/Contr:
..-/ .
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
&11J'
"~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
J. White
2. Pink
3. Yellow
File
City
Applicam
4--/ z-o (q I
Permit No. ~4{)()
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
/t.:,9/() L 0/0('1<;; A-VE s.E.
3. LEGAL DESCRIPTION
1. DATE
4/201;9
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
ADDITION
BLOCK
sovnt
~
12. NO. OF STORIES
LOT
I()
P!2-lOrL
PID ?<=; -on - Illr 0
13. TYPE OF CONSTRUCTION
14. OWNER
R/ffYOp-L
15. ARCHITECT
6. BUILDER
(Name)
ff.!:!/Vfl/ E,...I
(Name)
(Address)
/25X::>
(Address)
S~PEE
(Tel. No.)
I'1EtOOW c;r 4'!t. -3$3A
/hrV
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBE~ 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"roof~ Porch 0
Re"siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19 PROPERTY DIMENSIONS 110. GULVERT 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
:Uilding ~Ch~r i~use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfonn";b~mns.
Signature license No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
ee:s
k/~
,
OFF STREET PARKING PILING LOGS D PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS D SETS
SPACES ON PLAN SURVEY D COPIES
PERMIT VALUATION ~S"1I1.>. 0"(.) PLOT PLAN D
TYPE OF CONSTRUCTION: I 11 III IV
Occupancy Group A 8 E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... <I:
Collective Street Fee ....................... <I:
Sewer Tap ................................... It
$
1~.fC)
Plan Check Fee .... ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing PennitFee ....................... $
I, 2.-~
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... <I:
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ ~
Other ......................................... ~
Sewer & Water Pennlt ...................... $
Gas Fireplace Pennlt ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
/~.oo
:":.F;()c:;.q_
Date
By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdina ce and ay proceed a requested. 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.
CltyPlannef
Date
Spec~1 Cond~ions K any
24 hour notice for all inspections 447.9850