HomeMy WebLinkAboutBuilding Permit 99-0583
DATE TIME
CITY OF PRIOR LAKE .Arr
INSPECTION NOTICE SCHEDULl'P 5-z., .Lf9
ADDRESS 53l.7 CD-ww.r:r ~,tk t?J
OWNER CONTR.
PHONE NO. PERMIT NO. '1'1-';-83
o FOOTING
o FRAMING
Dv~SULATION
f\1 FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: ~J
'~ ~v>-[k,~
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
tJ SITE INSPECTION
o EXCJGRADfFlLLlNG
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
./
)\WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
;;;~E;,
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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l. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. QQ,S83
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE ALLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT '-/- BLOCK J PID 2S' 2.9',,, OOof....v
ADDITION NOJe.TH S HPI2E OA-/~S 6-nf
4. OWNER (Tel. No.)
t./4~ - ntl
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
7. TYPE OF WORK
New Construction LJ
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Fireplace LJ
Alterations LJ
Septic 0
Addition LJ
Deck 0
Finish Attic 0
Re-roofing ~ Porch 0
Re-siding 0 Finish Basement (j
SEATS
16. PROJECT COSTNALUE
Chimney LI Misc.
B. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
17. COMPLETION DATE
Yes No
I hereby.certify that 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
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
building official r k this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ,;lOII1XI'l., pAc..... I~ ('1'1(1
Signature license No J Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
/Ze"5 ~/.<.
(
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS LI
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z. rv-o. cru
PLOT PLAN
o
TYPE OF CONSTRUCTION, I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Pennit Fee ................................... $
74.1('"
Plan Check Fee .... ......................... $
State Surcharge ............................. $
Penalty ............................... .... .... $
Plumbing Permit Fee ....................... $
I. z...S-
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Flrepl ce Permit ....................... $
~iS Iding ~:t:'it~t~*~
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7'. cFO
Paid '7 4 . cflJ Receipt No. ~ S 1\ 'L
Issued / A JA.. _
Date 5:/11 'Rtf 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 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.
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850