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HomeMy WebLinkAboutBuilding Permit 99-1037 " {~ I II I " f/V;.I.~ ~- /111 ~ f I, ((~ '\.. \. / vU 0 \...- "'-.... ~ 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: . . / \ I ~ (( /J .,. / / LK SATISFA~ORY' P OCEED o CORRECT ACTI NAND B o CORRECT WOR , A FO qh.1~4 ~ TIME ,4r ~- 1037 o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o ~ /--;/ 'I II I~ II f) J t '-'" ~ - 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 --,-_."_.---~~-~--~----_.,_. ----~-"-_..._-_.__...__.- &~~ DATE RECEIVED e//q /r:Jc; 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. g -/'l-1? 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 - -- - - . 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 'l5 t:KJ - PLOT PLAN " 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