HomeMy WebLinkAboutBuilding Permit 99-1107
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
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ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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99-1107
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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DATE RECEtVFD
9/7/91.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2, SIT~ ADDRESS .A _
/1,,"'37l./ ;fk"zK ~
Permit No.
c;Q - //07
,-
1. DATE
tj - 7 -'1 '1
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
LOT
3. LEGAL DESCRIPTION
3
RISI;)
BLOCK
4-
P"'!elC-
12. NO. OF STORIES
PID
2.t!:i -o9~ - O()Z-O
ADDITION
LAK.F,l'tO t='
13. TYPE OF CONSTRUCTION
140WN~A-T
t. ARCHlTEC:
\~E~
(Name) (Address)
D r tfA-al'l-
(Name) (Address)
(Tel, No,)
'. 14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Name)
Fireplace [j
Alterations 1:1
(Address) (Ter. No.)
l&~~ MII.IN S-(. S",f
P.L. ~~...~
Septic LJ Deck 1:1 Rs-roofing\3=- Porch LJ
Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
t:;ep.( Wl-\~T
7. TYPE OF WORK
New Construction LJ
C {> ,.:r,f'l:A<!:tr ~
Chimney 0 Misc.
/8. PAOPERTY AREA OR ACRES
Sq. Ft.
I hereby certify that
the above mantio
building officia
SEATS
16. PROJECT COSTNALUE
19. PROPERTY DIMENSIONS /10. CULVERT SIZE
Width Depth Yes No
ave furnished infol1T1ation on this application which is to the besI of my knowledge true and correct. I also certify that I am the owner or authorized agent for
prope nd that all construction will conform 10 all existing state and local Jaws and will proceed in accordance with submitted plans. I am aware that the
yoke pe 10' jusl cause. Furthemmm, I he,eby ag'ee Ihallhe oily offldal 0' a designee may enle' upon Ihe propeny 10 perto'm needed '19CtiOns.
::l-e:> f f"~ ~ . <; - 7- '7
License No. Dale I
I 17. COMPLETION DATE
x
Signature
FOR ADMINISTRATIVE USE
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
KES .4-/L
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I /I III tV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
S U
City:
Amount Brought FO/Ward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meier Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WalerTap ................................... $
Builder's Deposit ............................ $
7417,}
/. Z.s
Mechanical Permit Fee ..................... q:
Sewer & Water Permit ...................... $
::1Ji;lriA~~;,~I~~~:I;~W~;41r!_
Certificate of Occup/ncy
Other ......................................... $
Total Due .............................. $
Paid "1 r;. (J7I Receipt No, <3 c:./l" 7 7
Date 9/7/ V 1 By ~
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 a~ 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.
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Issued
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850