HomeMy WebLinkAboutBuilding Permit 99-1298
,DATE TIME
CITY OF PRIOR LAKE 16 :lR;>
INSPECTION NOTICE SCHEDULED 11 'ZZ g~
c;\e.ne{n}l". I
ADDRESS \4.S"04
OWNER CONTR.
PHONE NO. PERMIT NO. QQ-I2.Gtf}
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~SULAr;g.N o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASLlNE AIR TST
SITE INSPECTION o MECH FINAL 0
COMMENTS:
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~RKSATI ACTORY
o CORREC ACT
o CORRE
Inspector: . Owner/Contr:
CALJ 447-986Q1FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~EQUJeMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
V INSNOTl
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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
Applicanl
Permit No. q i -I L"l~
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
,>'s.-Cl'-{ i:l(",,,,1.u..k \\'" <<~
3. LEGAL DESCRIPTION
1. DATE
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
to
BLOCK
13{j/JDINS n/t/J{')!2
PID ~5 -/2/- ml" -0
ADDITION
4. OWNER
\II\,\"C{\
5. ARCHhECT
2 ^!J2
13. TYPE OF CONSTRUCTION
6. BUILDER
(Name) (Address) ~"", "r. (Tel. No.)
t\f'.dW :'> CIA 1'-1$;'".( (,Io",j",..",-
(Name) (Address) (Tel. No.)
(Name) (Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
_t'1~\-(r>_
7. TYPE OF WORK
New Construction CI
~I'\~~,
Fireplace 0
Alterations 0
ltl~'(
Septic CI
Addition CI
(bIZ)
W. WijHe).."-,- ~"'J.. ~()"'- 1'1gl(
Deck Re-roofing CI Porch 0
Finish Attic CI Re-siding 0 Finish Basement CI
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTC;:;
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERlY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that r 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 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 off~ can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins ions.
X -p.. ft.i:A:r J)M~ )03 0 q a;
\) ~ Signature License No. Da
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FilED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA CI
PILING lOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
ll4A. o/K
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION "2. ">00.00
SURVEY
PLOT PLAN
CI COPIES
o
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV lV
Occupancy Group A B E F HIM '"'G> S U
0"'''''0 1 2(j). 7'-11S""
Permit Fee ................................... $ .
City:
Amount Brought Forward .................. $
Park Support Fee ............. .... .... ...... $
SAC ......................................... $
Collective Street Fee ....................... Of
Sewer Tap ................................... <t
.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ...................... ......... ........ $
I . L. '15'
Plumbing Permit Fee ....................... $
0.1 09/'
\.o-~ ~\
!x\d-
Pressure Reducer .......................... $
Meter Hom ................ .... .... ........... <t
Water Meter ................................. <r
Sewer & Water Connection Fee ........... <t
Mechanical Permit Fee ..................... $
WaterTowerFee ........................... $
Water Tap ................................... <t
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. S 7"'.0 ()
Paid -,,,. 0 0 ReCBip\.IJo."\( " '-I'll
Issued lAIr...
Date lO-l..'1~l By ~u
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 as re~uested. 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.
City Planner
Dale
Special Conditions if any
24 hour notice for aU inspections 447-9850