HomeMy WebLinkAboutBuilding Permit 99-0479
ADDRESS
L/-798
DATE TIME
SCHEDULED S/;Of11 3:l>O
77'1 ebl1 A-
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~9-4-:;q
,
o EXC/GRAD/FILlING
o lKSHOR6NYETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o FOOTING
o FRAMING
~NSULATlON
FINAL ~~
OUNDATION
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
COMMENTS:
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%. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PR' ~EEO
o CORRECT WORK, CALL 'e : REINSPECTION BEFORE COVERING
Inspector: """I, [ \ . Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~1
Q.6TC" Clcr.If'l\l.E.Q.
0-/3/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'';ft /11
1. White
2, Pink
3. Yellow
File
City
Applicant
Permit No.
c;c; - 1/77
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. BilE ,ADDRESS ...,.- (
J...f1 Wf., I/AC0l1l1tL )-("(')[
3. LEGAL DESCRIPTION
/L/ BLOCK 0
PtlZ I o/z- SOc./-rrl
14.0WNER f2..1/1 (Name)
rilL/I a
5. ARCHITECT (Name)
BUILDING INFORMATioN
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
PID 2S-01( -12-0 - ()
13. TYPE OF CONSTRUCTION
ADDITION
111Qvlr1as
(Address~ .
f5lil1 ,
(Address)
(I ara~
(; (Tel No) it 1;1 -
. 0lK.". ij'-lf)- 44:37
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name)
Dtut\l...
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
oCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic D
Addition 0
Oeck 0
Finish Attic 0
Re.roofln~ Porch (]
Re-siding 0 f Finish Basement 0
SEATS
'6. PROJECT CoSTNALUE
Chimney (] Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that 1 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
:Uild' icial an voke this rmit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to p~i4nqections.
License No. Date I'
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING OEPARTMENT VALUATION
USE OF BUILDING
/Zn 11/~
PLANS & SPECS D
SURVEY 0
SETS
COPIES
PERMIT VALUATION
25Cf() _ au
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 '74/. 7 r
Permit Fee ................................... $
Plan Check Fee ............................. $'
City:
Amount Brought Forward .................. $
Park Support Fee ........ ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
State Surcharge ............................. $
Penalty ............................... ........ $
/..z...;
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... ~
Builder's Deposit ............................ $
Other ......................................... <t
Sewer & Water Permit ...................... $
~~;it1;t7~:,;itWrJ1d~
Certificate of Occupaf
Issued
Total Due .............................. 4'
7~.oO
Receipt No. 3' r- /..J- <-I
~
Paid 7'. en./"
Date ~h lif1
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 as 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.
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850