HomeMy WebLinkAboutBuilding Permit 99-0529
,
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
TIME
SCHEDULED
1-B - q't
AT
ADDRESS \ ~ 3 b 3 M. and t1 h
Al//"_
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq - 529
o FOOTING
o FRAMING
~I ULATION
INAL
FOUNDATION
o DEMOLITION
o FIRE PREV.
COMMENTS:
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nerJ ~
.---- ~ -~ ~
( ./UI'ffPL +r~. )
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o PLUMBING RI
o MECHANICAL
o WAfER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
O~hSiTN
o EXC/GRAO/FILLING
o LKSHOREnMETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
LK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT w~~ 'rLL FOR REINSPECTION BEFORE COVERING
Inspector: ~) Owner/Contr:
'- I
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
15A;;~Cf1
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Q9-SZ-9
,
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
Ilt3(p~ mOJ1dtr\-A1~
3. LEGAL DESCRIPTION
"
Prior (~ r.'W 5531 d-...
~I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
8A!.OO~ v',t..t..€
3
fit (A... S
PID ;2..5-0IfD- 0"2...7-0
ADDITION
2AJ.b
13. TYPE OF CONSTRUCTION
4i OW!J,Ef _ n (Name)
Vi:b ~ tf.dn'fJ 'a
5. ARCHITECT (Name)
$,dzJ<<...
(Address)
1103l.!'~~P,,,,~ /oJ
(Address)
(Tel. No.)
fA (1".4'11~"W8
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT"
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding ~ Finish Basement 0
SEATS
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. FI. Width Depth Yes No
I hereby certify that I have fumished 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
buUdin)J"OJi:f1 can revGke th~eb~ust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfolT)l.Ll.eeded ins~ions.
X. -HJ:l/UUtI J h.( Q J .:::>-11- qq
, - - Signature License No. Date
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Bad<
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/ZE.S ~/L
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
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PLOT PLAN
o
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 ................................... $
7o./,1)'
Plan Check Fee ............................. $
State Surcharge ............................. $
I.~)
$
Penalty ....................................... ~
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ Cf::
Other ......................................... Cf::
Total Due .............................. Cf::
7(" .00
Mechanical ParmitFae ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
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I c/
Certificate of Occupancy
Pa;d "1 t.. iO Reca;pt No. ;;J: c-/4 I
ISSUed,. _ /.-..
Data -;;~q 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 Jl"~~ested. 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