HomeMy WebLinkAboutBuilding Permit 99-0477
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
~qf
SCHEDUlED r; -(-99
/17owor ,Pol
fiT
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Qtj-'i71
IT
o FOOTING
o FRAMING
~NSULATI'1I'
FINAL KbO P
FOUNDA liON
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/FILlING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
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OK
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~E~S~T~~A1fCT~RY' :::::~
o CORREe OR A FOR REINSPECTION BEFORE COVERING
Inspecto Owner/Contr:
CAL -4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
6~~
DATE RECEIVED
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.
91 - 1/77
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
54q/
3. LEGAL DESCRIPTION
tylCY"l ,., r
RrJ
1. DATE
5-3-'1/
ktSt,
LOT
ADDITION
BLOCK
,J'M ArldFLfn
4. OWNER
fV\r HtIr~
5. ARCHITECT
(Name)
L..~~ ~<~
(Name)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
$.E
PID /~") -070. OO( {)
&,I&.<:.,;m HOlM/-':
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address)
(Address)
(Tel. No.)
'11./0-
(Tel. No.)
14. FlOOR AREA APPORTIONMENT USE
6 BUILDER (Name) (Address)
f.-l "l ,...:.., s .; let.:.., ~fItJ".J" '-:1
~OJ .... 9-:l.. /SC'^'-.d- ~:-
7. TYPE OF WORK Fireplace 0 Septic 0
New Construction 0 Alterations 0 Addition 0
Chimney 0 Misc.
(Tel. No.)
(,S/-1./.37
~N.~<"^31. "7~"7
D'9ck 0 Re-roofing.P"" Porch a
Finish Attic 0 Re-sidlng.?" Finish Basement 0
SEAT~
16. PROJECT COSTNALUE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
17. COMPLETION DATE
8. PRDPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
~by certlfy that I have furnished i lonnalJon on this application which is 10 the best of my knowledge true and correct. J also certify that I am the owner or authorized agent for
(the above mentioned prope onstruction. will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins~ons.
X ) ')~'./.3~l/;}- S-.1-7"1'
<c:::.."- S' License No. Date
SETBACKS: Required
Actual
Front
- BUILDING DEPARTMENT VALUATION
/1'5 /'4 / f;
USE OF BUILDING /6? "
/
TYPE OF CONSTRUCTION; I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ........................... .... .... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
FOR ADMINISTRATIVE USE
Back
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
Side
Side
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION ~_OO PLOT PLAN 0
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... II::
SAC ......................................... cr.
Collective Street Fee ....................... <I'
Sewer Tap ................................... $
$
--N -7~
/ .J<:
Pressure Reducer .......................... $
Meter Horn ... .... ................. .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... II::
Builder's Deposit ............................ $
Other ......................................... $
Total DueOV.......................... $~. ~ 1f:>.00
Pa;d 10.~ Rece;ptNo., 15/l/
Issued Date ').J -Y 1 By ( } KJ.-.J
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 as requestl6. 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
Certificate of Occupancy
CityPlannef
Date
Special Conditions if any
24 hour notice for all inspections 447.9850