HomeMy WebLinkAboutBuilding Permit #99-0786
DATE TIME
CITY OF PRIOR LA,KE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS:
/41372-
# /-f.r;
f{!.UTGE7<..S
SCHEDULED
CONTR.
PERMIT NO.
9'1- 7B(P
o PLUMBING RI 0 EXC/GRAD/FILLtNG
o MECHANICAL 0 LKSHORElWETLAND
o WATER HOOKUP 0 COMPLAINT
o SEWER HOOKUP 0 SEPTIC FINAL
o SEPTIC INSTALL 0 FIREPLACE
o PLUMBING FINAL ft RMF P'//I./At.--
~ 0 SITE INSPECTION
'tWI f~ ~n,~
I ' 0
,.11..1\ I/k:l.-.,("<"")
( '/ft<:YL
:J JI~
LK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOr9~lJOR REINSPECTION BEFORE COVERING
Inspector: J[l; It- \ Owner/Contr:
)
CALL 4474230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby carti t furnished infonnation on this application which is to the best of my knowledge true and correct. , also certify that I am the owner or authorized agent for
entioned pro rty 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
isl can ra e this permit for just cause. Furthermore, I hereby agree that the city official or a deSign,ae may enter upon the property to perfr neede~ iiJSP~
~ ~ , ---'P ~l..-4 "1-1-
Signature license No. Date
B~\.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
6~r;;7fq .
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
4 V\-~
b.2L(.,Q
'~tL l aIL JL
2. S~~S ';") _
\ 4--:') 12 ~t:-L7A S.
3. LEGAL DESCRIPTION \
PID7,:;;430-1J5h-O
LOT
BLOCK
ADDITION
4. OWNER
1'1~'/~S IN 8IH/NOS
___~~+-~~ (AddreSS)~
b({~lWD .o?f./-/
(Tel. No.)
5. ARCHITECT
(Name)
(Address)
6. BUILDER (Name) (Address)
Lec- GleA ~
7. TYPE OF WORK Fireplace'L1 Septic 0 Deck D
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
(Tel. No.)
Re.roofin~ Porch a
Re-siding 0 Finish Basement a
x
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qtf' - 7Be,
BUILDING INFORMATION
-11. SIZE OF STRUCTURE
(Heighl) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .............. ~
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Ham ............................ ....... $
Water Meter ................................. f,
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
.:J..nJ?).OV
USE OF BUILDING
,e6.S A-l.e.
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~~~i~.~..~...~...~..~... q: 74. ~
City,
Plan Check Fee ............................. ct.
( 2-~
State Surcharge ............................. $
Penalty ...................... ................. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $-
MATERIAL FILED WITH APPLICATION
SOIL TESTS LI ENERGY DATA LI
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS LI
SURVEY LI
SETS
COPIES
PLOT PLAN
o
..................... $ Water Tap ................................... $
ThiS es y/lJ .Q'lldlng PennitWh~ Ap~ Builder's Deposit ............................ $
By ~ Date ~I '1 "/ Other ......................................... $
Cert'f'C9leoloccup!:;7 Total Due .............................. $...2(;..00
I ed Peid "'11(, cfO Receipl Np, :~ 5 5~ 2-
ssu 'Dale io/z. t/ / t['f By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinake and may proceed - 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.
24 hour notice for aU inspections 447-9850
Special Conditions W any
City Planner
Date
-----.--.----...-. ~-.,._--_._-_..__.-
---..----------------