HomeMy WebLinkAboutBuilding Permit 99-0462
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CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FRAMING
o INSULA liON
o FINAL
o FOUNDATION
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
TIME
4-1 ()/)
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o EXCIGRADIFILlING
o LKSHORENVETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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COMMENTS,
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r,"",,)_ _ pVI" .
;( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT ION BEFORE COVERING
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Inspector: _
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2 Pink
3 Yellow
File
City
Applicant
Permit No. qq-~2-
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
/~/ 2--/ .sr. PRVC- AVe:. .J e
1.CATE
4-/2-q!q1
,(f2-
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
COJ rcu.O s
PID 25"-00'; - /)2.7 ~ 0
ADDITION
~
\ ... JWNER (Name)
~ G ~ v'Q tJ S,d, 1M eL,'!-
15, ARCHITECT (Name) V
6. BUILDER (Name)
Avo /II .
13. TYPE OF CONSTRUCTION
(Address)
LGI:l.I
(Address)
(Tel. No,)
SfPav IA.V'SCGof""J:-W:1-L'i39
(Te1. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTI'
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch a
Re-sidin;>(' Finish Basement 0
SEATS
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
~~~7 ~I'I can revoke this pe'1' lor Il'ft cause, Furthemmre. I h"eby ag,.e thai the city official or a designee may enter upon the property '0 perto",! npeded Inspections,
. X _l'GJ"-OAA 0PVA."",""O<L~AC ""(-'J-9-r?
I Sig~ature J License No. Dale
17. COMPLETION DATE
I
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPUCA TION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
R-e-<; A:( e.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS LI
SURVEY 0
SETS
COPIES
PERMIT VALUATION
? ~-6V
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Clly'
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Division 1 2 3 4
Permit Fee ................................... $
"14- .l~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty............................... .... .... $
(""2..~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WalerTower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Pennit ....................... $
This Application Becomes Your Building Permit When Approved.
By late
Certificate of Occupancy
-/Ct? .0 0
Paid ""1~. CfU Recelp' No, :''5"10 ("
Issued I /. ~
Date 4- U t1 By'
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinarke anJ may 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.
CnyPlanner
Date
Special Conditions ij any
24 hour notice for all inspections 447-9850