HomeMy WebLinkAboutBuilding Permit 99-1233
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 4B:b c.,.t,~ ,"';-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
4ESULATIONA
INAL
SITE INSPECTION
COMMENTS: Zp
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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TIME
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
Inspector:
REINSPECTION BEFORE COVERING
Owner/Contr:
HE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
:s ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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DAIF r::U::r:Fll1.E.Q.
/O/IZ-/~.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS LL /
,S-O 0 C a (() fZ.a..r/O
sf:
1. DATE
I f)-I;).. - q 1
122-
3. LEGAL DESCRIPTION
LOT
PID 2S~OI- /27-0
ADDITION
BLOCK
/IJ&"Te5 /IN~ 8tJvN'n"
4. OWNER ( (Name)
M../(otl/",
5. ARCHITECT (Name)
(Address)
<,c ~ o !vi Belt 5MIotC
(Address)
(bw#~- 8'fo 7
(Tel. No.)
6. BUILDEFtiELA H~Iti'i'l(j <I< ltMVIVu"Llm'1:A!illIk,)
4100 EXCELSIOR BLVD.
ST. LOUIS PARK, MN 55416
*e~'~~:'Jl
(Tel. No.)
'I'.;43-5'01{
Re-roofin* Porch LI
Rs-siding 0 Finish Basement 0
7. TYPE OF WORK
Septic 0
Addition LJ
Deck 0
Finllh Attic 0
New Construction LI
Alterations LI
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9r- /233
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
,-;-6"7)"
17. COMPLETION DATE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 11 Q. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished 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 local laws and will proceed in accordance with submitted plans. I am aware that the
building o~cia~ can rev9jce !t'is p~ for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections.
X /;~SY /#rt) (O-/~-9?
----<c,/" V Signature License No. Dale
Amount Brought Forward .................. $
Pari< Support Fee ........................... or
SAC ......................................... $
Collective Street Fee .......................4:
Sewer Tap ................................... $
Pressure Reducer .......................... 4:
Meter Horn .................... ............... <I:
Water Meter ................................. ct
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... ~
Builder's Deposit ............................ ~
Other ..........................................It:
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
..ok
Side
Side
BUII.DING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PI.AN
PERMIT VALUATION
2- 57:YD. nO
USE OF BUILDING
d2e.s "'V L.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ............................... .... $
Plan Check Fee ......................... .... $
State Surcharge ............................. $
S U
City:
7</. 7 r
/."lor
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
This
By
uilding Permi! Whe~pt7'~
Date /0 V.
(
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOI.ATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
$
7tl-Q()
Paid 7'. QU Receipt Nq. :~, 4-/4--
Issued I / ~
Date '0 (uqCj By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdina~ce ~d may proce s 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.
Total Due .............................. ~
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850