HomeMy WebLinkAboutBuilding Permit 99-0613
SCHEDULED.
DATE
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TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
/.l, T,
ADDRESS
/5 L/0 0
OWNER
CONTR.
PHONE NO,
PERMIT NO.
q 9 - G /3
o FOOTING
o FRAMING ft)
o NSULATION 4.
FINAL ~OO ~
~~OUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRADIFILLING
o LKSHORENYETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS: -r'I"'.J r ~ 1fA')J;
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L SATISFACTORY, PROCEED
o CORRECT ACTION AND PR~D
o CORRECT WORKfff1R INSPECTION BEFORE COVERING
Inspector: (1)1.;1 I Owner/Contr:
, V .
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
Chimney Ll Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certi at 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 abov entia ad property and that all construction will conform to all existing state and local Jaws and will proceed in accordance with submitted plans. I am aware that the
buildin official c revoke this pe"!1iU,gr just ca~se. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to pertolTl) needed jn:>~ections.
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,;;r-- " Signature License No. Dale
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
/5" ~GA)
1. DATE
Sf.
C . 0
n2- 25 ' f 9
,
III J !7
C'\
rlf~/J1N
(II PI' ~
3. LEGAL DESCRIPTION
3
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ADDITION
3
'" ':to t2 h 5
. (Address) ~"J ,1
/ SV02-...J r~,7I1.AI
(Address)
LOT
PID
25-0<11-015-D.
BLOCK
4. Ol1~; .
~{
A (TeLN~.) y~~_
{/ /.?"'* q ?5-:A-3
(Tet. No.)
(Name)
6. BUILDER
(Name)
(Address)
(TeL No.)
~011Atil ~/.;~ *'/~/~/Iik~,j~~~j".'1 $;'-5"/J>6
7. TYPE OF WORK Firepface rl Septic rl Deck [j; Re-roofing ~ Porch [j
New Construction [j Alterations D Addition LJ Finish Attic LJ Re-siding LJ Finish Basement 0
1. While
2. Pink
3. Yellow
File
City
Applicanl
Permit No.
qq-(,13
BUILDING INFORMATION
11. SIZE OF STRUCTURE
{Height} (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTP
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ '710. CI\)
Paid 7" .{JV Receipt!:l.P. :gS:;: 4-1
Date 'S1?_~/q0 BY-1U1
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning brdinanbe and'may proceed a/;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.
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDiNG
eF5 A. / f2-.
PERMIT VALUATION
z.Slfb . UV
TYPE OF CONSlllUCTlON: I iI Iii IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
-,4-_ '1e:;-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ............. $
I.~
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... $
Sewer & Water PermIt ...................... $
Permit. ..................... $
;~~ .~Iding ;:t:,ij vgt-t1~1
Certificate of OcctJpincy
Issued
Cily Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
MATERIAL FILED WITH APPLICA nON
SOIL TESTS rl ENERGY DATA 0
PiLING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS Ll
SURVEY 0
SETS
COPIES
PLOT PLAN
Ll
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