HomeMy WebLinkAboutBuilding Permit 99-0803
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
~FINAL !eoo&:"
o FOUNDA rlON
o DEMOLITION
o FIRE PREVo
fgMMENTS:
DATE TIME
?P1hQ 2:00
J qO ~ ..sT.
SCHEOUtEO
39"0
CONTR.
-
PERMIT NO.
o FJLUMSING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
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t31f~
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o EXC/GRAO/FllllNG
o LKSHORElWETLANO
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
.
-
iRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~ C~LL FOR REINSPECTION BEFORE COVERING
Inspector: &t)f, . Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCIb
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFHTYI
t~~
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicanl
Permit No.
99 . yr as
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADORE; q,t, D 14 D k.. ~ + N J,(J
3. LEGAL DESCRIPTION
1. DATE.
At
BUILDING INFORMATION
11. SIZE OF STRVCr uHt::
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
=lLOCK
//V dlu/lllar
PID 25 -QZ2..-00.5 - 0
ADDlTION ~~ /~.....
4. OWNER (Name) ,
/::),/" \,.., hv\.c:?\D ~ ,
~HITECT . (Name)
13. TYPE OF CONSTRUCTION
(Address) ~
/~<1tL,D d D sJ .
(Address)
jTel. No.)
~rS-
(Tel. No.)
" 14. FLOOR AREA APPORTIONMENT USE
7 ~"'LZJ
I
I
6. BUILDER
(Name)
(Address) (Tel. No.) , 15. NUMBER OF OCCUPANTS OR SEATS
/1 &."'1~ uJ.//DI<J /3J" --r~7-/9.k""
;J;q:-,1. {....Z.Je../I ~potL h-J!.r... -
Fireplace LJ ,$eptic LJ Deck 0 Re-roofing'-- Porch LJ I
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 /16. PROJECT COSTNALUE
" 17. COMPLETION DATE
I
OCCUPANTS
~it::io:/ L
New Construction LJ
SEATS
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished info on 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 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUildi~ yn revo~.J1is pe . r just ~~ Furthermore, I hereby agree that the city official or a design,ee may enter upon the property to perform needed inspections.
~d:::'ffl // r.. . ~-.l:.F- qq
:./ ,/ Sig ure ~ :.__~ license No. Date '
/
FOR ADMINISTRATIVE USE
~t; I I:IA\,,:I'\.::': Heqwrea
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
J2j!:;" S ,et/ k:-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY D
SETS
COPIES
Z- s:-vv. VV
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III 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 ................................... $
$
7407>
Plan Check Fee ............................. $
State Surcharge ............................. ~
Penalty ....................................... $
I. {, ("
Thi
By
P rrnit.. ................... $
.,ding Pennit VJ't "Ppn,e,
-Date r., B- Ii
- / 1
Pressure Reducer .......................... $
Meter Hom... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7th, Cf?/ Receipt ~o, "So ,r1 f
Issued . ~ ~
Date ~ {( By
This is to certify that the request!n the above applicatio~ and accom~nying ~uments is in accordance. with the City ZonindOrdina ce and may .... ~.~...... 'requested. TtiiSdoc~ment 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.
7'-.00
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
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