HomeMy WebLinkAboutBuilding Permit 99-0655
CITY OF PRIOR LAKE
IhSPECnON NOTICE
SCHEDULED
DATe TIME
~3'~
ADDRESS
/0~28 Lmscw-
OWNER
PHONE NO.
-
CONTRo
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PERMIT NO.
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o FOOTING
o FRAMING
o INSULATION
~F1NAL ~oo,::
o FOUNDA rlON
o DEMOLITION
o FIRE PREV.
A
o PLUMBING RI
o MeCHANICAL
o WA TER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SIrE INSPECTION
99-(,55
-
o EXC/GRAOlF'lL'NG
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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-
I
V
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/
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Owner/Cantc
CODE ,!EQUIR 'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.\
QAIE..RFr:eWFn
~ /1 /11
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/1. DATE
5'-27-'1"1
'1()i17
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Clt(-("s-
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
\ioL/:1~
=i>t l.l S (, '^-
A lJQ -) e..
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
3. LEGAL DESCRIPTION
BLOCK
.:3
12. NO. OF STORIES
LOT
ADDITION
4. OWNER
K\rK.
5. ARCHITECT
/2-
8/Loo/CSvl <-(-'~
PID .?-5 - 0 If, - tJ33-0
(Name)
y'\it <<i.JM
(Name)
\"'Y.Jl~
(Address) (Tel. No.) I
B't\. Sl.u... Av" <;~ - 7UL
(Address) (Ter. No.) I
.1
13. TYPE OF CONSTRUCTION
r-e..c~~
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name) (Address) (Tel. No.)
, " .70"7 -b9S9
~~~~~;~B~\\!\~,1~?,,~\rM~~~I~{d~~~ko"\;LO\\~!o~~ S. Porch"
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Ae-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEAT~
Chimney 0 Misc.
I~. PROJECT COST~LUE
c; 7-00
/17. COMPLETION DATE
8. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. 2b 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 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
building offic,.~ revok~ ~ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .7".--..K.;Y -...o/6'7-S~} ~-"2-7-7q
Signature
License No.
0.10
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILEO WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS i:J
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~ H/IC-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PERMIT VALUATION
Z.rv<J ~ ~
PLOT PLAN
"
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... Of'
SAC ......................................... $
Collective Street Fee ....................... t
Sewer Tap ...................................4::
.
Penni! Fee ................................... $
-'..{.1C
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
I.'l..r
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meier Horn ... .... .... ........................ $
Water Meier ................................. $
Sewer & Water Connection Fee ........... 4:
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ 4:
Other ......................................... L.-f1-,' A iSJ-
Total Due .............................. $----1..1.t--'
Pa;d 7Ce.uc- Rece;pt No. ~ C~"7 I
Date 1,111&1&1 By ~ .
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceecitl 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.
Permit. .................... $
uilding ~:r:it vgef'lrqt:,
, f
This
By
Issued
cny Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850