HomeMy WebLinkAboutBuilding Permit 99-0504
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 1100/7
OWNER _ ~
PHONE NO,
SCHEDULED
DA Te TIME
c~ c..
CONTR,
- -
PERMIT NO, _Cfq_ ~()'i
~-1'i ~
o FOOTING
o FRAMING
.:: !!:/SULA TION^
~'NAL t-'<
o FOUNOA rlOH
o OEMOllTION
o FIRE PREVo
COMMENTS:
o PLUMSING RI
o MECHANICAL
o \'VATER HOOKUP
o SEWeR HOOKUP
o SEPTIC INSTALL
o PLUMS/NG FINAL
o SITE INSPECTION
o eXC/GRAO/F'LllNG
o lKSHORElWerLANO
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
- =- =-
= ~
- ~
~
=-
Inspector:
-- Owner/Contr: _
R THE NEXT INSPECTION 24 HOURS IN ADVANCE,
&~~.
QA TF RFr.J:w~n
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
NAY 71999
I DIRECTIONS .
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2il:?rC'JtWl61(/~C c!:: {-I tCO-c- ~f2
Permit No. 2,9 - s-vl
3. LEGAL DESCRIPTION
1:'OATE
5~ 7~Cf9
PI2.JDI!... L;>\}' ve
BUILDING INFORMATION
", SIZE OF STRUCTURE
(Height) (Width) (Depth)
ADDITION
LOT t)~ Z-
PR I 0/2.
(<J1'lfupV
t:.. eLf RCrAJ
, BLOCK
PID z5-00 '-62-0 - C
A-t'4e-e:::. 2 A/O RoaN.
,;r;~s~ ~/~
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
4. OWNER
<:::; "[?Sc&J
5. ARCHITECT
(Name)
4J~~ / l/'[i/-
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
6. BUILDER
rl
';;> LrJ rr
7, TYPE OF WORK
New Construction 0
(Address)
(Tel. No.)
(Name)
14Ft
rJlUoR ~l<E
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTR
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofingYS Porch 0
Re-siding 0 Finish Basement 0
SEATS
16, PROJECT COSTNALUE
J
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished informatio on this a ication which is to the beSI of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above menU e property and th t aU true' ill conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
build;ng o!f;ci ke Ih;s permit 0 ' e, ermore, I hereby agree that Ihe city olf;c;al or a designee may enter upon the property to pertorm need~nsll'fjio,ns,
X~" ~ 0 J~ t!)~/~'1 '1
--- - Signature - Ucense No. Date
17, COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2e:S. "'T1,L
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION '2- c- 00. Cl 0
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B. E F HIM R
Division 1 2 3 4
Permit Fee .................. .... ............. $
S U
City:
Amount Brought Forward .................. ~
Park Support Fee ........................... $
SAC ........................................, $
Collective Street Fee ....................... $
Sewer Tap ................................... <l:
$
7";' 7r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty............................... ........ $
/. 'Z- r-
Pressure Reducer .......................... $
Meter Hom ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
7". dO
Total Due .............................. $
Pa;d 74. CI'-' Receipt No, 3 ~/o.f V
Date <:'/'7/9'1 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 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.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This l6lc:At/x. "",.oml Y~ld;ng Perm;t whefppf;ed,
By f~ r -zJVi.- Date $' 7 f1
I '" . ,
Certificate 01 Occupancy
Issued
City Planner
Date
Special Conditions W any
24 hour notice for aU inspections 447-9850