HomeMy WebLinkAboutBuilding Permit 99-0436
CITY OF PRIOR LAKe
INSpeCTION NOTIce
ADDRess
SCHeDULeD
DATe
TIMe
COMMeNTS:
o EXCIGRAOlFllllNG
Q L/(SHORElWeTLANO
Q COMPLAINT
o SEPTIC FINAL
V~~:.E_. _
)'\-~€"
WoRK SA TISFACTORY, PROCeED
Q CORReCT ACTION ANO PROceeD
Q CORReCT WOR/(, CALL FOR RelNSpeCTION BeFORe COVeRING
Inspector: ~ OWner/COntr:
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DATE RECEIw;Q"
4-/z.-:"/CJ1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3 Yellow
File
City
Applicant
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
/~"':?1
3. LEGAL DESCRIPTION
LOT 1<;2.
1. DATE
Permit No. ~4:~<'o
LI.h- 9'7
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
I.hrfi, I~
12/'1
12. NO. OF STORIES
BLOCK
NoR.:ntwooO
PID 25"-I4-1-00\-n
ADDITION
4. OWNER
~
5. ARCHITECT
13. TYPE OF CONSTRUCTION
(Name)
L~VI ,',-1
(Name)
I (Address)
~~?~
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.) I
K.bdi~ M '-I1//J'1Wa...
(Tel. No.) 1
.1
14. FLOOR AREA APPORTIONMENT USE
(Tel.
No.)
f{(#/ 349"~
15. NUMBER OF OCCUPANTS OR SEATS
A fI"j'.J.-d
LML
~t(tf}~ A-c ~
OCCUPANT~
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Rs-roofing 0 Porch 0
Re-siding~ Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULvt:~7 ;;:~
Sq. FI. 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' d propertyrTn th8trJl nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offic reJ.9~ this it for' cause. Furthermore, I hereby agree that the city official o~ a des.!2nee may enter upon the property 10 p~ ~ed ~pections.
X .(/rj.. d~ - '}111~?77 -r-'</-7'j
v~ yr-/Signalurf/" Lk;enseNo. Dale
.- - ----
) t. \JUMt-'LETION DATE
,
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
- BUILDING DEPARTMENT VALUATION
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
USE OF BUILDING ~5 1'\f.E-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
'2--~ ~ .
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
CHy:
Amount Brought Forward .................. $
Park Support Fee ........................... ,0;::
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Permit Fee ................................... $
14--,1~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
(,2-"""-
.
Mechanical Permit Fee ......... .... ........ $
Pressure Reducer .......................... $
Meter Hom .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... 4'
WaterTowerFee ........................... or
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7r..dD
Paid 1(.. . cJ7.;> Receipt No. .., ro K'1
Issued ~ I
Date tl-I qCf. By I; .--/
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ~rdlna ce and may proceed 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 f Occupancy must be issued.
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Dale
Special Conditions if any
24 hour nolice for all inspections 447-9850