HomeMy WebLinkAboutBuilding Permit 99-0818
ADDRESS
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DATE TIME
SCHEDULEI;'. 7- u-qq /6 ; ],0
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'14-
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D FOOTING
o FRAMING
~SULATION
INAL
FOUNDA lION
o DEMOLITION
o FIREPREV. ~
COMMENTS
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If /Q~IJ ~i L . U
lA:J.1 L-.> . 'i1I\
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o PLUMBING RI
o MECHANICAL
o WA lER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILlING
o LKSHORE/WETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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SPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL ~74230 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~MENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
~77;:;
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
1. DATE
">~/- 9<:}
/ Co fI.'7 mlllkbA.- ~ S. e.
3. LEGAL DESCRIPTION ~c."z:-r~ ~. ~""'fj1.1 lr ;r.e!'.QtV-UI~ ..,.. 7l1.o1r,"Y
:>~IO'" n<.4..~,\
LOT BLOCK PID 25 -I~7 - 1136 - I
ADDITION P1&775!: /N 80c.J/l/OS
4. OWNER (Name)
SCOT( Co_
5. ARCHITECT (Name)
(Address)
(Tel. No.)
C/2.- t../0-R2? J
,4-rr,oJ.' W,-lllil~e~ I-A-
(Tel. NoJ
(;, ~-32.J-d'(JI.tL
..5T~ / Co
Re-roofinglt" Porch 0
Re-siding (] Finish Basement 0
/-/If.,4-
(Address)
6. BUILDER (Name) ~ I' (Address)
S'~t-/f ~""'/N1 ef: ~c--
!rIO'!> fxu'~ /'f/J.// .~r: fo<.<'; l /"!:! k
7. TYPE OF WORK Fireplace 0 "Septic 0 Deck D
New Construction Q Alterations 0 Addition 0 Finish Attic D
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No,
9CJ-B/e
BUILDING INFORMATION
.
11. SIZE OF STRUCTURE
(Height) (Widtt1) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJE<;J}9~tro 0 .
17. COMPLETION DATE
Chimney D Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. 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 men' Eid p erty 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
building offici ca rev: e this #m~ust cause. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X /C,!JJL /050 ~_p '3-1/~? ,>-/-qc,
. -.... Signature - Lice~se No. Date f
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... ~,
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... 'l:
Water Tap ................................... <t.
Builder's Deposit ............................ $
Other ......................................... Of:
Total Oue .............................. $ SC:::> l. ,S
Paid 5?P /, 7 r Receipt No. .3!:S!:fl (i
Issued
Date 7/1/9'1 By 410. ____
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~q~~ed. 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.
SETBACKS: Required
Actual
Side
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION
4(,.000. -
USE OF BUILDING
~f!. H/.e-
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
City:
Division 1 2 3 4
Permit Fee ................................... $
s ;,2, .15
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
1.?i. DO
Mechanical Permit Fee ..................... $
Certificate of Occupancy
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
24 hour notice for all inspections 447-9850
Special Conditions if any
Cify Planner
Date