HomeMy WebLinkAboutBuilding Permit 99-0629
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 9-;),7-9'1 A../.
,
ADDRESS / -45"73 M-A-PL E / /21r/'--
OWNER W1 ^ f.H2. CONTR.
PHONE NO. PERMIT NO. ., 99 - &.;)9
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION @ o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS~ ~ ~
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LSATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORPlCALL FOR REINSPECTION BEFORE COVERING
Inspector:~. Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
-~-~-_._._---------_.._-
7. TYPE OF WORK Fireplace 0 Septic 0
New Construction 0 Alterations 0 Addition 0
ChimneyLl MiSC.~~ t7~;C
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. FI. Width Depth Yes No
I hereby certify that I have fum' ed 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 m~ntio ed prope nd th II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offici r ok . perm' just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf~ needed)nsRections.
X ;:) ';2-6- '79
/ ' Signature License No. Date
~.
I.}ATl= Rl=r.l=1YED.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
5/zr../qq
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12SITEAn~r~ 7 3 7J2~/)
1. DATE
~ -;/6- 9'1
K'ISD
3. LEGAL DESCRIPTION
LOT
1J1~ r
ADDITION
.3
O"qe.L -'1 N P L5' C7? O+! 4- 77f
(Addre$sl
M/i~1L /4573
(Address)
(Tel. No.)
J
BLOCK
PID 25-/38 - 0/9- 0
ItrJnAl .
i11~/t' Tr4! (Tel;i/7_3l<t:/
14. OWNER J/ 4..1 (Nam<l) /I
Ilffr'7 ; Lvl'!
5. ARCHITECT ( (Name)
6. BUIL~~
(Name) I (Add~esl.l 5
La h,1401M'?l~.,t "1 J4
pc-
/)Jl-JcM -:?~)
L/L/72cr.;o
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
Deck 0
Finish Attic 0
1. White
2. Pink
3. Yellow
File
CiIY
Applicanl
Permit No. qq; tbZ.fl
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
OCCUPANTS
SEATS
16. PROJECT COSTNAlUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. Of.
Park Support Fee ........................... $
SAC ......................................... 'l:
Collective Street Fee ....................... Of:
Sewer Tap ................................... $
.
SETBACKS: Required
Actual
Side
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
;;;)~.(fV
USE OF BUILDING
~e.s A/L
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
7q. -;S-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/2."
MATERIAL FilED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY LI
SETS
COPIES
PLOT PLAN
LI
Pressure Reducer .......................... $
Meter Horn ................ ................... Of:
Water Meter ................................. ~
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7 c.. D 7J Receipt ~o, 3 '53<11
Date ~/2,,/9q By 1AtL-
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 J. 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.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Condrtions ~ any
24 hour notice for all inspections 447-9850
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