HomeMy WebLinkAboutBuilding Permit 99-0633
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
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OWNER
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CONTR.
ADDRESS \4'1.<;n
PHONE NO.
PERMIT NO.
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o FOOTING
o FRAMING
o INSULA TIONllr-
'b<FINAL r
/0 FOUNDATION
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
D WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORENYETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
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COMMENTS:
Roof
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o WORK SATISFACTORY, PROCEED
o CORRECT ACT N AND PROCEED
L FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspector:
CALL
30 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
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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.
99 ~ t.3~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
2. SITE ADDRESS
It..JQ':;-6PlltIE, POltVr CArZ.
1. DATE
3. LEGAL DESCRIPTION
h
S~;;L(,. - r cr BUILDING INFORMATION
11. SIZE OF STRUCTURE
,t..,I ~ 0 (Heighl) (Width) (Oepth)
12. NO. OF STORIES
LOT
BLOCK
/~r ,4-PPN
PID Z.'--O',/7--olJ8..:[)
-ro ~ /t.</ouO
13. TYPE OF CONSTRUCTION
ADDITION
4.0f'11r J.J
5. ARCHITECT
(Name)
!LiNE-
(Name)
(Address)
LtJ ~ ()'f'-J
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
Fireplace 0
Alterations 0
Deck 0
Finish Anic 0
t../ 'f1IJ':...N040'S
SP,:~ Po~hO
Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
6. BUILDER (Name) (Address)
rn(Jl1~ f?Vl U)&~ ":,;l ..,"'"
fi5"30 tv/~5 .PI
7. TYPE OF WORK
New Construction CI
OCCUPANTS
Septic 0
Addition 0
SEATS
16. PROJECT COSTNALUE
Chimney LI Misc.
la. PROPERTY AREA OR ACRES
Sq.Ft.
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
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 a t ned 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
in ffici 'revo~e ~pe~r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf~neeQpd inspections.
~-f__~- __ ~d-(. ~74'
~ SignaturJ License No. Date .
17. COMPLETION DATE
SETBACKS: Required
Actual
L/
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICA nON
Front
Saok
Side
Side
SOIL TESTS
o ENERGY DATA
o
/U3S ~/..e-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS CI PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
z.rzfU. on
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division , 2 3 4
S U
City:
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... <t
Sewer Tap ................................... <t
Permit Fee .......... ............ ............. $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
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I. z.r
$
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... <t
Meter Horn ................................... 4'
Water Meter ................................. $
Sewer & WaterConnectlon Fee ........... <t
Water Tower Fee ........................... <t
Water Tap ................................... <t
Builder's Deposit ............................ $
Other ......................................... It
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Pennit When Approved.
By Date
Total Due .............................. $ 7t,. 0 0
Paid 'Ji'R.O 0 Receipt No. .3 '" ~ D
Issued
Date~{O/f''? ByA~___
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordlance and may proceed4ts 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