HomeMy WebLinkAboutBuilding Permit 99-0832
CITY Of'I-RIOR LAKE
INSPECTION NOTICE
DATE
TlMt:
SCHEDULED
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ADDRESS Li3e> \
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s.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CfI- ffZ-
o FOOTING
o FRAMING it
o INSULA liON
'\i1 FINAL
o FOUNDA TI N
o DEMOLITION
o FIRE PREV.
COMMENTS:
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~
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXCfGRAO/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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~r .P.IT /l~
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WORKSAT~SAl7.n .SED
o CORRECT AC I AND PEED
o CORRECT " ' :ALL F R REIN$PECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL ~7.4t30 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
;i~C79q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. qq - ~z..
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEF.O~J~~BMIT IS ISSUED (Please Print or Type and sign at bottom)
: .......,",..>",.. ','" ..
2. SITE ADDRESS (J
1j35?/ J~h~ L?~ A/
3. LEGAL DESCRIPTION
5
P/Oote..
1. DATE
hl/f'~
BUILDING INFORMATION
"11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
12. NO. OF STORIES
LOT
BLOCK
:3
r1UES
PID 2S-0oB~O'3~O
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name) r/ L7
~"':1,4& ~~
5. ARCt:iITECT (Name)-
(Address)
If '11/
(Address)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
New Construction (j
Chimney (j Misc.
B. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation 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 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 official ca oke this permit fo' just caus~ FU!Y'ermme, I he'eby agree that the city offl~al 0' a designee may ente' upon the pro1-'0 zonn needed Insp~ons.
X ~ ~ ~- ?/
Signature .- Ucense No. ' Date
Fireplace (j
Alterations (j
Septic (j
Addition 0
Deck 0
Finish Attic 0
Re-roofing)( Porch 0
Re-siding 0 ' Finish Basement 0
16. PROJECT COSTNALUE
7. TYPE OF WORK
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
I MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS Cl PERCOLATION TESTS Cl
USE OF BUILDING
k!.BS ,#f/~
,
OFF STREET PARKING
SPACES REO
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
- BUILDING DEPARTMENT VALUATION
z ~ - c;/""'"'
PLOT PLAN
Cl
TYPE OF CONSTRUCTION: I " 111 IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought FOlWard .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... ot
Sewer Tap ................................... <to
<
Pressure Reducer .......................... $
Meter Hom ........................ .... ....... 0;:
Water Meter ................................. <t,
Sewer & Water Connection Fee ........... It,
Permit Fee ................................... $
'74. 7\'""
Plan Check Fee .... ......................... $
State Surcharge ............................. $
Penalty ................................... .... $
/. -z..-S'""'"'"
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
Thl
WaterTowerFee ........................... $
Water Tap ................................... CI:
Builder's Deposit ............................ $
Other ......................................... $-
Total Due .............................. $ 7 (, .q 0
Paid ?fI. d 0 Receipt No. 351, I '9
Issued . .
Date? q By ~
This Is to certify that the ,""uest In the above application and accompanying documents Is In accordance with the City Zonl g O,dlnance and may p'oceed al.:;uested. 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.
.................... $
"ding ~:t";lt~j~t!f,
Sewer & Water Permit ...................... 0;:
B
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850