HomeMy WebLinkAboutBuilding Permit 99-0414
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHI!DULED
4 -'q)
PfI;
ADDRESS
llo'1.&'l B1\\...),., _ kc... ~ -r- -
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4'~ - Lfl~
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o FOOTING
o FRAMING
o INSULATION .J
)(FINAL e - trr
o FOUNDATIbit'
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
o EXC/GRAD/FILLlNG
o LKSHORENYETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
,/l",.L L...-- V '7f~ .1
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.......
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)('WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT ION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I DIRECTIONS
SPACES NUMBERED 1 THAU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
114'l87 BLAND L.AKE TRAIL
I ;;;L! q OJ
12. 1'50
3. LEGAL DESCRIPTION
14-
Pl2.wte.. SOtJll-f
4. OWNER (Nameh (Address)
8n6 J~~y ct!: (.en"", /6 q RIJ
5. ARCHITECT (Name) (Address)
LOT
5
PIO ~/5-017 -~q(,-O
/,.-, <.~'fJ ~
J.._,_ ~
n (Tel. No.) ~ r
OLJA ID iAKJr IFJ'1./L
(Tel. No.)
BLOCK
ADDITION
6. BUILDE;R (Name) (Address) c:...... '" ''''''' -M/V (Tel. No.)
~fl~RY :5:I9N17EPJ;P S~e fOil. bl~
() Uft11..f.2.ffi Cb/IJ't'R 11C7?1r':< '1330 Y<t:J1f? K fh 1<.5'. . [/4-1-0 "33
7. TYPE OF WORK Fireplace 0 Septic 0 Deck D Re-rOOfin~ Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
1. White
2. Pink
3. Yellow
File
City
Appllcanl
Permit No.
qq-4/4-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
~-~
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATP
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. 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
bUildi~ can revoke this ~it fO~iU . Furthermore, I hereby agree that the city official or a deSign.ee may enter upon the property to pertorm ne~d inSPec17' ns.
C~ "'f-h",-- ;;(O!74-~~_;J.. ~~ tr
l J Signature Y" License No. , Date I
17. COMPLETION DATE
~
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .... .... ,_ $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Horn .................... ........ ....... <t
Water Meter ................................. <t
Sewer & Water Connection Fee ........... It:
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... !f,
Paid T4-%:J~q..........~~~~;;;~o$ 3~~~08C
Dale --i(,. cio By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may prOCeed's 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.
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~,(J{J
USE OF BUILDING
e.E S Aj.12-
TYPE OF CONSTRUCTION: I II 111 IV V
Occupancy Group A B E F HIM A
Division 1 2 3 4
S U
City:
Permit Fee ................................... $
Plan Check Fee ............................. $
Ic./../~
State Surcharge ............................. $
'.2..S"
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Dare
Certificate of Occupancy
Issued
City Planner
Dale
Special Conditions if any
24 hour notice for alt Inspections 447.9850
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS D
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES