HomeMy WebLinkAboutBuilding Permit #99-1244
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.~",."'-;;F PRIOR LAKE
,;.}:,,'" INSPECTION NOTICE
DATE
TIME
SCHED!lLED
1((, u/rt
~.T.
ADDRESS
t'o57/ ,evSTlC ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ9-/z.f4-
o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLlNG
o FOUNDATION Jr 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ FINAL I!.()()r 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECTION ~c..n .INAL \
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fo ~~RRECT
o CORRECT
I
Inspector:
ROCEED
FOR REINSPECTION BEFORE COVERING
Owner/Contr:
TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
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/0/;3/91.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
Permit No.
CJ9~ / z44-
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS ,\
(.,.51 }(u5T~ r I<cA
1. DATE
/0 - 13- 9<1
leIS 0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT
/
I
1$ CHtJ.If 3 ~
(Address) I. n \
6:2....1/ KurtLfnl
(Address)
12. NO. OF STORIES
BLOCK
(J"1'KL/'IN D
4. OWN\ PI ~ k (Nat) ku
5. ARCHITECT (Name)
PID
2.'5-/37- 001-0
13. TYPE OF CONSTRUCTION
ADDITION
(Tel. No.)
4Lj1-/..,h:1 0
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
\ /Db -
6J<EltT ?)~~tJ5' F",J~~>_n~J
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
B,u
Porch 0
Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. 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 prope and thai all construction t'lI conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
bUjldi~ial can revoke pe It fo b' st c~s~ Fu ermore, I hereby agree that the city official or a designee may enter upon the property to pertorm ::eded ~P~ionS.
X ~ Q"'" . ,.,\,~. r 10 13 '\'~
Signature license No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2e::s R'ft'Z-
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS (j
SURVEY 0
SETS
COPIES
.2 c;07;.Af?J
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
,
Division 1 2 3 4
Permit Fee .................. ......... .... .... $
7-1. 75
Plan Check Fee ............................. $
State Surcharge ............................. ~
I~ z...,-
Penalty.......................... ............. $
Pressure Reducer
,
Meter Horn ................................... $
Water Meter ................................. $-
Sewer & Water Connection Fee ........... $-
Water Tower Fee ........................... <r
Water Tap ................................... ct
Builder's Deposit ............................ CI::
Other ......................................... :;:
Plumbing Permit Fee ....................... !l;
Mechanical Permit Fee ..................... !l;
Sewer & Water Permit ...................... $
Total Due .............................. CI::
Paid "'''.0 CJ Receipt No. 3r.." ~ z..
Issued I . J. t,IU /
Data '/d/01'l'1 By , ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinance and may proceed 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.
7lP.O 0
CityPlannef
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850