HomeMy WebLinkAboutBuilding Permit 99-0644
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUlED
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ADDRESS 1(" 77l>
ANN/4- 1;,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Gl't-Wlj
o FOOTING
o FRAMING ~
o SULATION 'A
FINAL I~
i!~UNDATION
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/GRADlFlLLlNG
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS: ~~_.~:;
-11.....& ,~ ~
17
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I iJJ.LW'
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'WORK SATISFACTORY, PROCEED
o CORRECT ACTION A 0 PROCEED
o CORRECT WO FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Conlr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE REC~IVED
S~7/cn
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.
C/ti -c, c/tj
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
7.;27/4"7_
.
te(
2. SITE ADDRESS /6 " 7 0
A h L. C'..Tr-c..; /
BUILDING INFORMATION
11. SIZE OF STRUCYURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
/
12. NO, OF STORIES
LOT
BLOCK
PID2~--o/~- 001-0
T:rO /tAr A/lIT
1/ a:,1~mt d CI.. Sea. r
5 ARCHITEfJ (Name)~ \-,
KCL~+I(I. COPJ'I-, LC{
6 BUILDER (Name) -J
ADDITION
13. TYPE OF CONSTRUCTION
4 OWNER
IAd/"b170 A "'/..All.
qoc;>e q~ ~+
(Address)
(Tel. No.) I'
lj'l7-~7
(Tel. ':!2;l "/A I
l<(69-;,<J~ul
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic 0
Addition 0
DeckCJ
Finish Attic 0
Re-roofin~ Porch D
Re-siding 0 Finish Basement 0
SEATS
New Construction D
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. 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 lt1e owner or authorized agent for
the above mentioned roperty 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
:uilding off' 'al n r :hl 7"r jusI cause. Funhermore, I hereby agree '206;ZQ Os 3~ may enler upon the property to pert~-:ed in:pectlOns.
~atura License No. ~~
16. ~JECT COSTNALUE
''1,'100 00_
, 17. COMPLETION DATE
--.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
K:ES ~
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
-z.... 'IDl ' cru
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 1"/.7 \
Permit Fee .................. ......... ........ $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ... ...... .............. $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I.z...r
Plumbing Pannit Fee ....................... $
Mechanical Pennit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & WaterPennit ...................... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Tolal Due ..............".............. $ 71b.oQ
Paid 14>, {J(,...- ReceiptNp, 353(., I
Issued A A.o, -'
Date <; /7.n / Ci <1 By/' ~
This is to certify that IIle request in the above application and accompanying documents is in accordance with the City Zoning Ordin'nce and may procee<ds requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to WIIIII n",...",. Before occupancy, a Certificate of Occupancy must be issued.
:!;;i;:~.l;~~i~~~:I;h~"hA~r~1
1~1.U\ lJ I'
Certificate of Occupancy
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447.9850