HomeMy WebLinkAboutBuilding Permit 99-1037
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CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDUL,ED
ADDRESS 4s 17 PI etu~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~SULATlOJL 0 SEWER HOOKUP
FINAL ~ 0 PLUMBING FINAL
o SITE INSPECTIOlPj MECH FINAL
COMMENTS:
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LK SATISFA~ORY' P OCEED
o CORRECT ACTI NAND B
o CORRECT WOR , A FO
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TIME
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~- 1037
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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ION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9860~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIRI MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
v/ INSIVOTl
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DATE RECEIVED
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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
Applicant
IDIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS '
Permit No.
99- /1J.31_
1. DATE
LOT
p ~d .5':1-
BLOCK 3
ADLJA.I.
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
11.1 /;;
3. LEGAL DESCRIPTION
2-/
t?A/i'::<~
14, OWNER &);'1 /11 dv
Iso ARCHITECT (Name)
6. BUILDER (Name)
12. NO. OF STORIES
PID 2.5-IlIlZ-03~-()
ADDITION
13. TYPE OF CONSTRUCTION
(Address)
SAMc;-
(Address)
(Tel. No,)
<011. . 4.& ..., - :!>lPS.3
(Tel. No,)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7, TYPE OF WORK
Fireplace tJ
Alterations tJ
Septic tJ
Addition tJ
DecktJ
Finish Attic tJ
Re-roofi~ Porch 0
Re-siding tJ Finish Basement 0
SEATS
New Construction 0
Chimney 0 Misc.
/a. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq. Ft. Width Depth Ves 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 aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding official can revo ethis pa""7' jU~J'l:Z:Z/' I hereby agreathat the city official or a designee may enter upon the property to perfo"'?":!J9~9
Signature License No. Dale '
16, PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
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- - .
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
"
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2F;" n/,p
,. ..
OFF STREET PARKING
SPACES REa,
SPACES ON PLAN
PERMIT V ALUA TION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
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PLOT PLAN
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TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
C;ty:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
74. 7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
/. z.r
. ............. $
uilding ;;r:lt ~~~ft?~
I I
Pressure Reducer .......................... $
Meter Hom ........................ .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... t.
Sewer & Water Permit ...................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 70. () 0
Paid '7rn.OO ReceiptNo, 3/;:700:$
Issued _.
. Date e/lq/qq B~
' ,
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proce as 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.
CilyPlanner
Date
Special Conditions ~ any
24 hour notice for aU inspections 447-9850