HomeMy WebLinkAboutBuilding Permit 99-0476
DATE
TIME
CITY OF PRIOR LAKE
INSP~CTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS:
v/u/111
.
/ {p / C" '-i- EWJ/V" STVIV'
SCIf"DULED
,if. T.
CONTR.
PERMIT NO. -49- <+?/i"
o PLUMBING RI 0 EXC/GRAD/FILLlNG
o MECHANICAL 0 LKSHORElWETLAND
o WATER HOOKUP 0 COMPLAINT
o SEWER HOOKUP @ 0 SEPTIC FINAL
o SEPTIC INSTALL If 0 FIREPLACE
o PLUMBING FINAL 1- Jl...fao,:= F/ 1\J4 &.-..,..
;;;? . 0 SITE INSPECTION '
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~ .,t7~., ~ e:I'~"......-
,
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LK SATISFACTORY. PROCEEO
o CORRECT ACTION AND PROCEED
o CORRECT Wrtf..A'fl FOR REINSPECTION BEFORE COVERING
Inspector: ....r~)fl. Owner/Contr:
V .
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
5~1
DATI; FlFGl=I'{fQ
5'/3/qt:j
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
!L1-'f1C
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
'573ffl
/2"2--
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
Jti(;4SS~v~ ~
3. LEGAL DESCRIPTION
.
LOT t1e175S' POUNOS BLOCK
S~
PID
I '2. NO, OF STORIES
25 -q 02.. -1'),,5-0
. I 13. TYPE OF CONSTRUCTION
I 14. FLOOR AREA APPORTIONMENT USE
I'~ mA~ ku.7,^O
(Tel. No.)
MO-:J..0'7D
ADDITION
~(Na~~
5. ARCHITECT' (Name) -
(Addr:~
(Address)
6. BUILDER (Name)
~{<~
,
t=ireplace LJ
Alterations 0
()O/i1i
(Tel. No.)
f'1t:l- ';:'l<;K
(Tel. No.)
~-&Jt\b
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Septic [j
Addition 0
DeckLl
Finish Attic 0
SEATF
New Construction 0
Chimney D Misc.
19. PROPERTY DIMENSIONS /10. CULVERT SIZE
Width Depth Yes No
'sh info '0 n~n thO pplication which is to the best of m.y knowledge true and correct. I also certify that I am the owner or authorized agent for
and at a nstruc . will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
pe " for u cause, unhermore, I hereby agree tha' the c"y official or a designee may enter upon 'he property '0 perlonn jJeffiections.
X'..) /Il/)() , '- '),
Signat~re -" License No. ~ate .
-4 \~J~Tci3STNALUE
17. COMPLETION DATE
8. PROPERTY AREA OR ACRES
Sq. Ft.
Front
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Ba'" Side Side SOIL TESTS C'I ENERGY DATA C'I
OFF STREET PARKING PILING LOGS C'I PERCOLATION TESTS C'I
SPACES REO. PLANS & SPECS C'I SETS
SPACES ON PLAN SURVEY C'I COPIES
PERMIT V ALUA TION Z-m""..., PLOT PLAN C'I
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING -1f.'E C KII?-
,
TYPE OF CONSTRUCTION: I II 111 IV V
OccupancyGroup A B E F HIM A S U
City:
Amount Brought Forward .................. <t
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .... .......... $
Sewer Tap ................................... $
Division 1 2 3 4
Permit Fee ................................... $
t4-,r
Plan Check Fee ............................. $
State Surcharge ............................. $
1- "'Z->
Penalty.......................... ............. $
$
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7'/~ . o-v Receipt Np.
Dale '~/pl'i1 By 1t-1.. ./
This is to certify that the request in the above a~lication and accompanying documents is in accordance with the City Zoning Ordinance and may proceed Is 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.
c Penn. .e~M~I~~i:,;.W~)jP/lf1
. -, I I
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Issued
~/~ . 00
3~/2--0
CilyPlanner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850