HomeMy WebLinkAboutBuilding Permit 99-0713
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUU;:D
rift '1
/I.-r.
ADDRESS
/(r;fR50
'-VONS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q q ~ 713
o FOOTING
o FRAMING
o INSULATION
I'!FINAL J!:.OOP'
o FOUNDATION
o DEMOLITION
o FIRE PREV.
COMMENTS((jJ)
t)
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEf'TIC INSTALL
o PL.UMBING FINAL
o SITE INSPECTION
o EXCIGRADIFILLING
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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o )JibRK SATISFACTORY, PROCEED
rI CORRECT ACTION AND PROCEED
o CORRECT ijO K ALL FOR REINSPECT ION BEFORE COVERING
Inspector: { Owner/Contr:
,\
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
-T'
DATF RI=~I=~
CITY OF PRIOR LAKE
BUILDING PERMIT,
'TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Permit No.
1'1 - 1/3
1. White
2. Pink
3. Yellow
File
City
APPli7'
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS ( L
Il /) fJC;1 f) \..ID(),<:'"
(Of\l~ (qdj"qO u). j;)3'h5t. (Tel Na.)
0C1..~ ~.., 4<-1S-49ocr
7. TYPE OF WORK Fireplace 0 Septic 0 De~O Re.roofing" Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
ChlmneyLl Misc. L/ S'on
lB. PROPERTY AREA O. R ACRES 190 PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. F' ;}Y' /3 D Width Depth Ye, No (.p - If? "'79
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 an~~lI c struction will conform to all existing state and local laws and will p.roceed in accordance with submitted plans. .1 am aware that the
building 0,r@\1 can revoke this pe t r ju cause. Furthermore, I hereby agree that the city official or a desig~e,!'l Tay enter upon the property to perfor1J1 need~ inw~s.
X (AL/}.L3-Y1 ~ ~ ( "X&."., {~~ & .. -7 -2 L
signature, 'License No. Date
3. LEGAL DESCRIPTION
'1
LOT
ADDITION P(Llof'~
140WNER .\Jd:'
15. ARCHITECT (Name)
6. BUilDER (Name)
L-E\J 't:.L. <C_d~<...
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
t:..e<,
I (;:q -1Cf
IJuf. .~~
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
BLOCK /
r
<;;"'U.'T#
C r (Address)
III r-..<..J-en; (VI
(Address)
1-.:;- 017- 001 - 0
PID
4t.flN~)4 r,;JLj
13. TYPE OF CONSrJ!jCl!JN
AJ NTfJfr _ .1 O~ .()
14. FLOOR ARt;jIl( APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
Front
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS Ll SETS
SURVEY Ll COPIES
PLOT PLAN Ll
B.o<
Side
/
Itl/.L
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
l.~OO. en)
TYPE OF CONSTRUCTION, I " ill IV V
Occupancy Group A B E F HIM R
Division 1 2 :3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ".""".."""""..""""",....... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
,4.7<;
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
(.2..<
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ............................ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
This
By
Certificate of Occupancy
Issued
u'._. It_ ,I
r BUilding perm:Whfm Im--;L.ed.
ate ~l(1
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1(,-00. Receipt No.
Date Gill l<tv
lCo. dO
'gS"431-
/l-IJI-t
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 as requested. This document when
signed by the CIIy Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
By
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
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