HomeMy WebLinkAboutBuilding Permit 99-0545
CITY"OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
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SCHEDULED 5)<; ;'7
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
C;1 -5&./S-
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDA rlON
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/GRADIFILLING
o LKSHOREIWETLANO
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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COMMENTS:
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A. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
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o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ---) , \-\ I
Owner/Contr:
CALL 4474230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
nATF pFr.FIYFn..
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 99- sk
- 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
/6~>J Alt,A,,<..hn/ fJLi.
1. DATE
$'-/3-97
~/SO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT I BLOCK
/V'Oer1-tWOOD
12. NO. OF STORIES
Z-
PID 25-14/,001-0
ADDITION
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
5~"'5"1-. tAh;eI'
5. ARCHITECT
(Name)
(Address)
<S"M€)
(Address)
(Tel. No.)
6;,.-'1'1<>-")] ~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
7. TYPE OF WORK
New Construction ~
Fireplace ~
Alterations ~
Septic ~
Addition ~
Deck ~
Finish Attic ~
Re-roofin~ Porch ~
Re-sldlng ~ Finish Basement LJ
OCCUPANTS
SEATS
15. PROJECT COSTNALUE
S"'-MA.
Chimney LI Misc.
8. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished Infonnation on this application which is to the bast of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above ntioned property and that all c ruction will confonn to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building I can rev7ke tho ennit for. c8.Use..$rthermore. I hereby agree that the city official or a designee may enter upon the property to perfonn needed i~ections.
. ""'-\./' <;-I3''1Q
~nature Ucense No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS (J ENERGY DATA 0
PILING LOGS (J PERCOLATION TESTS (J
PLANS & SPECS (J SETS
SURVEY (J COPIES
PLOT PLAN (J
BUILDING DEPARTMENT VALUATION
USE OF BUILDING Jt!:..6"5
K/ IZ-
OFF STREET PARKING
SPACES REO
SPACES ON PLAN
PERMIT VALUATION
2. nru ~
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
D""oo 1 2 3 4 7<./-,1~
Permit Fee ...................... ............. $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. .01:
I. !.-\
Penalty ....................................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other .........................................4'
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ......... .... ........ $
Sewer & Water Permit ...................... $
;;:~tjft~~;I~'~~:t;"W~Pi;1
Certificate of acLpancy
71#.UU
Paid 7{", I7C ReceiPt No. 3rJ7../-
Issued ./_ ~ .
Date Sf nIt; ~ 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 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.
Total Due .............................. $
CilyPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447.9850