HomeMy WebLinkAboutBuilding Permit 99-0508
~TY OF PRIOR LAKE
INSPECTION NOTICE
DATE
TIME
SCHEDULED
S-2/..{-9'l
10: 3,,_
ADDRESS /5228
Fish P.,.
R.&
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'19-5~
o FOOTING
o FRAMING
~I SULATIONA_
INAL t'{
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/FILLlNG
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
ITJME~1t / fuj,~ bllf- ~ f1A1A
1{lJr~i~'Yf, <ht.. eh.dv""T<<O ~ f- ~
CU.JJM/
kfA. rA1t /
./
O~
~
Y'/
o RK SAT'SFAff' I l{OCEED
CORRECT ACT! NO I ~OCE
o CORRECT WaR, L I' REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447~230 JOR THE NEXT INSPECTION 24 HOURS I'" AnVA"'CF
=EMtj-"'~_~_HEMm"~F';"
,..-
",,[0,,_" ',' "
r
~~
"DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'1)= / Lie;
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT [S ISSUED (Please Print or Type and sign at bottom)
12, SITIE ~~:;S D'
;;>..<"" n !'d'L V",..;.J k...d.L.
1. DATE
3. LEGAL DESCRIPTION.O
LOT /
5'-"j-9tf
I!rsb
BLOCK , Plods --v39 - 6'11-0
If! -UlK-e. _1UIe1'
ADDITION
lJ2fjj}6
4. OWNER (Name)
!.Jrvv,_<.# ". c:r ~
5. ARCH1TEC? .-. (Name)
(Address) (Tel. No.)
1")77 ')( ~J2U:.l-lZ-hO <(C(05-1'f2.
(Address) (Tel. No.)
1. White
2. Pink
], Yellow
File
Cily
Applicant
Permit No.
0l-V)~
BUILDING INFORMATION
11. SIZE OF" I HUt.; I uAE
(Height) (Width)
(Depth)
12. NO, OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
15, NUMBER OF OCCU~ANTS OR SEATS
OCCUPANTS
Chirnnoyn Misc. ~______._~_________,___
8. PROPERTY AREA OR ACRES /9, 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 besl of my knowledge true and correct. I also certify that I am the owner or authorized agent lor
the a en' ned property and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware thatlhe
buildin lei an r ke lhi~it fo),iust cause. Furthermore, I hereby agree Ihallhe city official or a designee may enter upon the property 10 perform needed inspections.
Zt -' -~./.c.:;.-.!'J.!/ j"}..---, /00/ 5-77'7
Signature license No Date
(Name)
&~~
7. TYPE OF WORK
New Construction 0
(Address) (Tel. No.)
33'(( ~ e....: g'1C[ooo (
~~ ~p~d.I.J..:--f0 /
Fireplace 0 Septic 0 Oet:k 0 Re-rooling ty' Porch 0
Alterations a Addition 0 Finish Allie n Ae-slding n Finish Basement 0
SEATS
16, PROJECT COSTNALUE
17, COMPLETlo.N DATE
SETBACKS: RequIred
Actual
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
MelerHorn................................... $
WalerMeler ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WalerTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Tolal Due W........................ $ 7C, ,00
Paid 10' --- Receipt No. '"3s-/S/'
- 1 ~ C; 7)' 1/,. :
Dale ,-') - -71' By ( , r-vu
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 reque&. This document when
signed by the City Planner constitutes a temporary Certificale of Zoning compliance and allows construction 10 commence. Before occupancy, a Certificate of Occupancy must be issued.
Front
Back
Side
Side
BUILDING DEPARTMENT VJj-UA TION
USE OF BUILDtNG J{J S ;If If(
OFF STREET PARKING
SPACES REO_ __'___~___
SPACES ON PLAN --,------------ .-----ro-..--~ .__,.__
PEAMITVALUATJON --~"W_--=---
TYPE OF CONSTRUCTION, I II III IV
Occupancy Group A B. E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ...................... ....... .<1:
V
R S U
7L/- 7')
I ' de;;-
Cily:
State Surcharge ............................. <l:
Penalty................................... .... $
Plumbing Permit Fee ....................... $
Mechanicai Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By )ale
Certificate of Occupancy
Issued
City Planner
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS [J ENERGY DATA 0
PILING lOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY [J COPIES -~---._---
PLOT PLAN [J
24 hour nolice 10f all inspections 447-9850
Special Conditions if any