HomeMy WebLinkAboutBuilding Permit 99-0762
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o DEMOLITION
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 14~B5
OWNER
PHONE NO.
DATE TIME
SCHEDULED
(.,-ZI-'iq
Ct;!;o
Mll.9le
1k.
CONTR. .......-- ________
PERMIT No\. _ qq - 7fc;""'"Z- )
-------------- .
o EXC/GRAD/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~A FOR REINSPECTION BEFORE COVERING
InspectDr: , Owner/Contr:
CALL 447 30 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
~~
QATF RFr.~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. While
2. Pink
3. Yellow
File
City
Applicant
(p i/ f3 /c;r
Permit No.
CJ9-7b2--
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom) ~ -I ~ - cr:7"
12. S~T~ ~DDRESS a/... "e/S.o
/4f?~"" ~.P..t"...:-- ~/L ~d -<Ar~ /YLJ ,1:~-=? / ..;<
,
5"
B~H
1. DATE
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT
3
,LOCK
PID.25 '/393-fJ3/-0
4-7lf
12. NO. O/)TORIES
I i":>
13. TYPE OF CONSTRUCTION
t&-,.?> ~..........
14. FLOOR AREA APPORTIONMENT USE
ADDITION
tJ/t /C-t-/'J NO
4~WNER . (Name) (Address) k (Tel No.) ~6?/1
~~" 1'7 ~~j~H.aP/"'-~"( $~ '<;#U ~--cr'7.2
5. ARCHITEC:T (Name) (Address)' (Tel. No.)
6. BUILDER (Name)
IVa-TMe-;("M ,f~I1..a:s--
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-rOOfing)l Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney LJ Misc.
18. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 1'0. 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 the owner or authorized agent for
the above m ntioned property and that all construction will conform 10 an existing state and local laws and will proceed in accordance with submitted plans. J am aware that the
building 0 lal can revoke t~~~ Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~-' 7 ,1) ~~;~~ 6 -/(:fJ- 9t;>
Signature Ucense No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
- BUILDING DEPARTMENT VALUATION
Back
Side
Side
SOIL TESTS
LJ ENERGY DATA
o
R.E.<:' AIK
;
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V ALUA TION
PILING LOGS LJ PERCOLATION TESTS LJ
USE OF BUILDING
PLANS & SPECS LJ
SURVEY 0
SETS
COPIES
2575J). tfD
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. .It:
Park Support Fee ........................... $
SAC .........................................$
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ...................... ............. $
7o./-.7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .................. ..................... $
J. z.-r
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ................................... $:
WalerMeler ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7" . o-c..,..- Receipt.No.
Issued
Date (p/1~/t!/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 proceed aVrequested. 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.
Mechanical Pennit Fee ..................... $
Sewer & Water Permit ...................... $
:fjI{;f?A'~;;.~
Certificate of Occupancy
'"1t;..CV
~.,,(3f
City Planner
0.10
Special Conditions ~ any
24 hour notice for all inspections 447-9850