HomeMy WebLinkAboutBuilding Permit 99-0739
DATE TIME
CITY OF PRIOR LAKE 7-r~9 A-r
INSPECTION NOTICE SCHEDULED
ADDRESS 2501 s:yu ~ I2.d
OWNER CONTR.
PHONE NO. PERMIT NO. qC;- 73q
o FOOTING 0 PLUMBING RI
o FRAMING 0 MECHANICAL
~SULATION 0 WATER HOOKUP
FINAL 0 SEWER HOOKUP
FOUNDATION 0 SEPTIC INSTALL
o DEMOLITION 0 PLUMBING FINAL
o FIRE PREV. I- r 0 SITE INSPECTION
COMMENTS: !2or,r,hJ
K.~ IA ()~
o EXC/GRAD/FILLING
o LKSHORENVETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WtF\.. RK.: C~LL FOR REINSPECTlON BEFORE COVERING
Inspector: \vj't OwnerlContr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
s~~
. DATE Rf!:CEIVFD
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
rir//c./91
- 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
250' sw SPRIN6r Ll'lkt;" Ro
3. LEGAL DESCRIPTION
1. White
2. Pink
3. Yellow
File
City
Applicanl
1. DATE
Permit No.
Cjq-737
(p - It, - '19
/CIS!:)
LOT
I
BLOCK
1?1" I ,-.A?...A/ U"f
B~rtt:!-r(
(Tel. No.)
1.11. ..... 5"- ..,""-/.
(Tel. No.)
PID 25 -f3/- ()Of-O
ADDITION
4. OWNER
PIlTrY
(Name)
Po.... 00'1
(Address)
~~AlQ.I..AIt.C
(Address)
ZSOI SLJ
~D
5. ARCHITECT
(Name)
6. BUILDER (Neme)
S/9N/XO ~l-'7Q.VIC~J
I!Ifi#O J''''N'iU'1
7. TYPE OF WORK
New Construction 0
(Address)
3/1)1 /'&' H. J1" C
I'~ cA- L f4.-/C.r #"'I1H
Fireplace CJ Septic CJ Deck 0
Alterations 0 Addition 0 Finish Attic 0
Re.roofingJr" Porch 0
Re-siding 0 Finish Basement 0
(Tel. No.)
.'z >/I,It>- 70' ~
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
lS. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 aU construction will conform to all eXIsting state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke this permit for just cause. Furthermore, J hereby agree that the city official or a designee may enter upon the property to perlorm needed inspections.
X~~E.~ Q.... ,",001"2.1 <.0-1"'-')<;
Signature a- License No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $:
Collective Street Fee .......................!I'.
Sewer Tap ................................... <I:
Pressure Reducer .......................... $
Meier Hom ................................... $
Water Meter ................................. It
Sewer & Water Connection Fee ........... It
WaterTowerFee ........................... Ci::
SETBACKS: Required
Actual
Front
Back
Side
Sicle
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
pF~
~~
PERMIT VALUATION
;lmJfl-
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 .................. ......... .... .... $
74- '/~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
I.<.-r
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
:fllJll~;:t;"707'o/!jr
Certificate of Occupa4
SOIL TESTS
LJ ENERGY DATA
,.,
PILING LOGS CJ PERCOLATION TESTS [J
PLANS & SPECS ,.,
SURVEY CJ
SETS
COPIES
PLOT PLAN
o
$
Water Tap ................................... ,ot
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Peld 'J'h . ao Rece,pt No :5 S" r 0 q
Issued #
Date {,,f,(P/ Q'1 By A:L6l /
ThIS IS to certify that the request In the above application and accompanYing documents IS In accordance With the CIty zonln6~ may pr~s requested ThiS document when
signed by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construction 10 commence. Before occupancy, a Certificate of OcCIJpancy must be ISSUed.
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447.9850
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