HomeMy WebLinkAboutBuilding Permit 99-0521
ADDRESS
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CITY OF PRIOR LAKE
INSPECTION NOTICE
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CONTR.
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OWNER
PHONE NO.
PERMIT NO.
o EXCIGRA.OIFIllING
o lKSHORE/lNETLAND
o COMPLAINT
@ 0 SEPTIC FINAL
8<' FIREPLACE
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o FOOTtNG
o FRAMING
o INSULA. TION
o FINAL
a FOUND" T10N
o DEMOL''T'ON
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
o W"'TER HOOKUP
o SEWER HOOKUP
o SEPtiC INSTALL
o PLUMBING fiNAL
a SITE INSPEC,.'ON
COMMENTS '
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WORK SATISFACTORY, PROCEED
o CORRECT AC"'ON AND PROCEED
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Inspector - owner/conlr
~\..\.. 447~230 FOR THE NEXT INSPECTIOl!?-4 HOURS IN @VANCE"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
s-;:;;Z;'q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
1. DATE
5-10-1~
2. SITE ADDRESS
1'-49'" FrtA..J ku~ TIlA~L
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3. LEGAL DESCRIPTION
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BLOCK J
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(Address)
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PID ]r::::;-n?3-t')()5-0
/tOON.
LOT
ADDrTlON
'" '2f. OWNER
~A?""J
5. ARCHITECT
2/010
(Tet. No.)
~1-7 -ild~~
(Tel. No.)
(Name)
~~'!HH/
(Name)
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
Jf# ll4.;iri!~~
1J>;f / ,;$-..'.II"P/ 4VE
.i/~7 -t527~
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
Re-roofin~ Porch 0
Re-siding 0 ,. Fl~sh Basement 0
Fireplace 0
Alterations 0
Deck 0
Finish Attic 0
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq . 52- /
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify t I 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
. ned property and th II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
can revoke this pe . r ju~use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform ~eeped ins~ions.
. A... . a /./J /99
S' ature ~~ license No. Date
Amount Brought Forward .................. $
ParkSupportFee ........................... $
SAC m...................................... $
CoUectiveStreet Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
USE OF BUILDING
~~5 A//Z.-
PERMIT VALUATION
~~ CJ U.crU
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4 7c1.75
Permit Fee ................................... ~
City:
Plan Check Fee ............................. If:
State Surcharge ............................. $
/,1.-1'"
Penalty................................... .... <;:
Plumbing Permit Fee ....................... <;:
Mechanical Permit Fee ..................... ct:
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA Ll
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
Ll
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
7(0.00
Total Due .............................. $
Pa;d 7Ct. (J 0 Rece;pt No. ~.r I.K'
Date ::JIlt, I tj 'l By 1!fO'---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 'OrdinJnce and may proceed atfequested. 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.
Sewer & Water Permit ...................... or
Th~
By
Issued
City Planner
Special Conditions if any
Date
24 hour notice for all inspections 447.9850