HomeMy WebLinkAboutBuilding Permit 99-0549
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
StHEDULED
'-1(., -'l'i
A--r
ADDRESS 1536q
IfFrttUl I? Rtf
,
PHONE NO.
CONTR.
PERMIT NO. qq- 51../9
OWNER
o FOOTING
o FRAMING
o INSULATION ~
.;=c('FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV.
COMMEI\IT~: ~
~
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXCfGRADfFILLlNG
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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cI WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wo~CtL FOR REINSPECTION BEFORE COVERING
Inspector: t'- j , Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
DATE RECEIV!;Q
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.
e(9 - 54q
j
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
12, SITE ADDRESS q <' 1 ~ 1
163 0 ~;::;~..;"I h c-G-bf
'~E/ 3.- r7
"hre-ez --f Pi, (2ds.c
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3, LEGAL DESCRIPTION
L
ADDITION B(26-E:;'Z.. '-1
{\~it~ ttnd fiSC3ll
12. NO, OF STORIES
LOT
BLOCK
P<9I~
PIC
1. r:,- () 7.-(" - ()O Z.-O
13. TYPE OF CONSTRUCTION
(Name)
(Address)
.<p.1h/
(Address)
ITeJ ~o)
bf'17,.<t;Cb1
14, FLOOR AREA APPORTIONMENT USE
4, OWNER
5, ARCHITECT
(Tel. No.)
7. TYPE OF WORK
New Construction LI
Fireplace 0
Alterations 0
(Addre~ 'n r? ~( (Tel. No,) fl
ISo 0 t c.11t't ~ (,;; [ 201tf
(l,url1SV' I U m"'G..:S~?7 7,;),10'
Re-roofin~ Porch 0
Rs-siding 0 / Fi~sh Basement LI
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
6. BUILDER (Name)
L\JS~~Ciy0/5
SepticLJ
Addition 0
DeckD
Finish Attic 0
SEATF-
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS
Sq. Ft. Width Depth
I hereby certify that I have furnished InformatIOn on thiS apphc
the above mentioned prope!!y and that on~~n III rm to al
bUilding offiCial can rev s pe lust ca 11 ore, I h
X 'Af"/ fA
....../J ,/
110. CULVERT SIZE
Yes No
,7
best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
isting state and local laws and will proceed in accordance with submitted plans. I am aware that the
-elgree that the City~oi ~a }es1:Jela7ter upon the property to perform $"edet.{~~' 'l
17. COMPLEtiON DATE
License No.
00"
r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
USE OF BUILDING
Res
/
A-/tL
I
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
'Z. sm 0
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION: I II HI IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .......... ............ ............. $
s u
City;
Amount Brought Forward .................. If:
Park Support Fee ........................... It
SAC ......................................... $
Collective Street Fee ....................... If:
Sewer Tap ................................... It:
$
'14 :'1')'
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty.......................... ............. $
Plumbing Permit Fee ....................... $
(.. 2...c;-
Mechanical Permit Fee ..................... $
Pressure Reducer ..........................!t
Meter Horn ................................... 4'
WalerMeter ................................. $
Sewer & Water Connection Fee ........... !"
WaterTowerFee ..........................._4'
Water Tap ................................... If:
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7&:>. C7U
Paid (cP: - . Receipt No, -Y:;/,'1
Date S'(('tlqt/f By tUJ/}- I
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 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.
Sewer & Water Permit ...................... $
Issued
C~yPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850