HomeMy WebLinkAboutBuilding Permit 99-0905
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/'-1 S3 '-f
OWNER
PHONE NO.
g ~~~II~~ ~
o INSULATION
~INAl
o FOUNDATION
o DEMOLITION
o FIRE PREV.
COMMENTS: &"p::
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DATE TIME
SCl-'.EDULEll 7-28-9'7 JQ', 00
S' fI-o I!.E L ~6
CONTR.
PERMIT NO.
CJC}-go5
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXCIGRAD/FILLlNG
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
0(l~.
..~
~ '\
~
./
L SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO", ~ALL FOR REINSPECTION BEFORE COVERING
Inspector: _ 111X' ( , Owner/Contr:
CALL 447-423D FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
..-----...-..-.--.-.--
!i~'i;
DA TF RFr.FJ'lE.Q
7 /Z 7/9.'1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicanf
Permit No.
99-90~
I DIRECTIONS
l-CES NUMBERED 1 THRU 17 MUST BE FILLED IN
lE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
';72- 7/JCj
'7:)534-
3. LEGAL DESCRIPTION
SHORE
tJ'IN6
PI/SD
BUILDING INFORMATION
". SIZE OF STRUCTURE
{Height} (Width) (Depth)
BLOCK
PI
El
<1711
12. NO. OF STORIES
LOT
ADDITION
:z...
SI9A1 0
PID ZJS-Z/5- /03-0
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
~AI(..crA./ .I D-7 ",!",-",T.u"
5. ARCHI CT (Name) v
(Address)
/L/<. ~'1
(Address)
(Tel. No.) I
SHVPnAN'r ..e-L- </~,S:- /A>~
(Tel. No.) I
.1
14. FLOOR AREA APPORTIONMENT USE
'.'-_.~
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing ro/ Porch 0
Re-siding 0 ~inish Basement 0
SEATC::
Chimney 0 Misc.
R PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 mentioned property and that all construction will conform to all existing state and Jocallaws and will proceed in accordance with submitted plans. I am aware that the
building officYi/7'al can re ke this permit f~usjJJduse. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perlonn n&eCIed inspections.
X .~. A' AY~/'Z,..J1~
'/ SignalurV'" License No. Dat9
16. PROJECT COSTNALUE
17. COMPLETION 01. TE
,ACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
LI
BUILDING DEPARTMENT VALUATION
.12&.5 ..-v ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
;ZStJO,tJo
PLOT PLAN
LI
TYPE OF CONSlRUCllON: I II III IV V
Occupancy Group A B E F HIM R S U
CNy'
Amount Brought Forward .................. 4:
Park Support Fee ........................... $
SAC ..................................,...... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee .......... ......................... $
Plan Check Fee ............................. $
State Surcharge ......................... .... $
7-/. 75
/. .1..s.-
Penalty ....................................... $
Pressure Reducer .......................... ct
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tap ................................... ,0:::
Builder's Deposit ............................ $
Other ......................................... $
Total Due ,............................. $ /".00
Paid /(p"07) Receipt No. 3!S"f,fr
-issued ." .
Date 7/~7/9f By ~
~ is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee~q:sted. 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.
:::~:~;I~,~~.~.e:~~nAop~y~a
By .~/t7~' Dete ~/-Z-171
Certificate of Occupancy
CijyPlanner
Dale
Special COI1dilions if any
24 hour notice lor all inspections 447-9850
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