HomeMy WebLinkAboutBuilding Permit 99-0595
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SC,IEDULED
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ADDRESS 33/3 <so...~ ~
qWNER
PHONE NO.
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o FIRE PREVo
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COMMENTS:
CONTR.
PERMIT NO.
99- 59~
o EXCIGRAD/FILLING
o LKSHORENVETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
D.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
r 0 SITE INSPECTION
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"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORJ1~ F~EINSPECTION BEFORE COVERING
Inspector: PJ- ~-I-- ) Owner/Contr:
CALL 447~23~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DA~ y~~r::l\/.ED.
*1/91
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I 1.DATE
1. White
2. Pink
3. Yellow
File
City
Applicanl
Permit No.
q<9-5~
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADllIIESS
7"3/ Z
<;;"tJ
s: UJ-77
I€/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
/.5
12. NO. OF STORIES
LOT
BLOCK
PID ..zs -/72., fJ r () , 0
ADDITION
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
c?DAr
5. ARCHITECT (Name)
? _ (Address) (
/JIeG K.H: ~ S"~~'
(Address)
(Tel. NO.) I
~/2- -tl-~O--gl Z(
(Tel. No.) I
I
14. FLOOR AREA APPORTIONMENT USE
6. SOltDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~,q
7. TYPE OF WORK
New Construction 0
OCCUPANT'"
Fireplace 0
Alterations 0
Septic 0
Addition LJ
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Ae-siding 0 Finish Basement LJ
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPEATY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth 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 ro at all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official c e this ~ for lust cau~urthennore, I hereby agree that the city official or a designee may enter upon the property 10 perform needed inspections.
X ..;-- ~ J ~-Z-t-<7'::;
l.. SIgnature r - License No. o.te
17. COMPLETION DATE
-
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS LJ PERCOLATION TESTS LJ
. BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~l3 S "l tt:-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS 0
SURVEY (]
SETS
COPIES
PERMIT VALUATION
Z. rrJV. cfV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .........................................4:
Collective Street Fee ....................... 4:
Sewer Tap ...................................4:
$
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
7'-l."1r
1.'2.-)
Penalty ....................................... $
Pressure Reducer .......................... $
Meier Horn ................................... $
Water Meter ................................. $
Sewer & WalerConnection Fee ........... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7(p.cro
Pa;d I~' Of) Rece;pt No. 1: r-~ z..,+
Date ~/7-dc,e, By 1J?--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina~ce and may proceed as ,@quested. 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.
Gas Fireplace Permit. .................... $
~~;s uUd;ng ;:,";;1/2 ir-'1'
Issued
City Planner
Dats
Special Conditions if any
24 hour notice for all inspections 447-9850
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