HomeMy WebLinkAboutBuilding Permit 99-0407
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
~~
AT
ADDRESS
I-/d-. (4
C""-"_h tV\/U-.. L,-..l .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
90J -40,
o FOOTING
o FRAMING
f). ~SULATION/') r_
r~ :!NAL ~Cl(;)"\
o FOUNDA rlON
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/GRAO/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR ,R\,NSPECTION BEFORE COVERING
Inspector: \ . \;\' Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
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QATF RFr'FIV'<J2 CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicam
1. DATE
Permit No. --99 - 407--
ADDITION
14. OWNER (Name) I Ii
I ~h \0~l
15. ARCHITECT (Name)
6. BUILDER (Name)
Waf;
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED {Please Print or Type and sign at bottom}
2SITEy73Sv ~rL~a-_ Lv-.
3. LEGAL OESCRIPTION
4-
H'I u..5;
Y1lo:]~!.~il4'~\ Y(,IJ,
v '2dJ~97
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
LOT
2-
CA~N;F:
12. NO. OF STORIES
1$1
prD Zc:;.- :z.M..-CJ3S-0
ADON.
BLOCK
(TeI.20')
(j~ -/?IX
(Tel. No.)
13. TYPE OF CONSTRUCTION
eo -I<OOF
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~( e Yl
7. TYPE OF WORK
New Construction CJ
Fireplace 0
Alterations CJ
Septic LJ
Addition 0
Deck 0
Finish Attic 0
Re.roofing~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
IS. PROPERTY AREA OR ACRES 190 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 men ioned property and tha II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building . i ca~ revq:this p~'t r just cause. Furthermore, I hereby agree that the city offidal r J ~s~ee may enter upon the property to perform needed inspecti)'.
X ,..., /~ - '1,<" '1 q-/J-~
,~ ig ure .-- License No. Da' ,.
17. COMPLETION DATE
Front
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
..ok Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION '2.. '.>o-v . tf'U PLOT PLAN 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
feel; A;/ IL-
p
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee .... ....................... 4-
SAC ......................................... <r:
Collective Street Fee ....................... <r:
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
14-"'~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ............................... ........ $
,. '2-<:)
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... <t
Meter Horn ... .... .... ................. ....... <r:
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ IfA.O 0
Paid ,".0 (") Receipt No. -::l,q)f4 Z.
Issued _ .
Oate 4-1z,1q~ By I;Jb---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin ce ana may proceed as4equested. 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
City Planner
Dale
Special Conditions ~ any
24 ,hour notice for all inspections 447~9850