HomeMy WebLinkAboutBUILDING PERMIT 88-161CITY OF PRIOR LAKE who 's -A
2. w Asasor
BUILDING PERMIT, 3. Pink - Applicant
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE C -
AND UTILITY CONNECTION PERMIT Permit No.
DIRECTIONS
1, DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
_� ..�
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom
BUILDING INFORMATION
G. SITE ADDRESS
11. SIZE OF STRUCTURE
(Height) hl (Do
_�th)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
li
SECTION- Z - / / - v Zi LOT BLOCK_
q
13. TYPE OF CONSTRUCTION
ADDITION l� / %n� f1 l��P�.t PARCEL NLWBFR ^' �iJ y U
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Y. OWNER (Name) (Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT
/LS 5'12 rill r L "V? -3 of
USE
5. ARCHITECT (Name) (Address) (Tel. ko.)
6. BUILDER (Name) (Address) (Tel. No.)
15. NUMBER OF OCCUPANTS OR
,!e- r�_ c S.�.�. yyl iso
SEATS
OCCUPANTS ,S
7. TYPE OF WORK Fireplace❑ Septic❑ Heating❑ ming❑ Plub Reroofing❑
SPATS
New Construction❑ Alterations Pl' Addition❑ Finish Attic❑ Reslding❑
1B. E IMATED VALUE
Finish Basement C Porch❑ Garage❑ Chimney❑ Mlac__
10O
8. PROPERTY AREA OR ACRES
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
17. COMPLETION DATE
Sp. Ft. act ° ° °
Width 1 70 Depth ,^. m
Ves No y/
z.
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Signature pals
FOR ADMINISTRATIVE USE
SETBACKS: Required _ MATERIAL FILED WITH APPLICATION
Actual — SOIL TESTS ❑ ENERGY DATA ❑
Frond Beck ads SIN
PILING LOGS ❑ PERCOLATION
PROPOSED GRADE FOUNDATION TEST ❑
IN RELATION TO CURB OR CROWN OFF STREET PARKIN PLANS &SPECS ❑ SETS
OF STREET SPACES RED.
US OF BWLDING 'V-f SPACES ON PLAN, - -,�� SURVEY ❑ COPIES
3 -� PERMIT VALUAT !`C G - — PLOT PLAN
TYPE OF CONSTRUCTION; i II III IV Amount Brought Forward ............. E
Occupancy Group A B E I ic" City: Park Dad ............................. $
Division st,131 ............................ $
Permit Fee E .ten Sae
......................
... .. Plumbing S
g
S ]. SO
Plan Checking Fee .................... Sewer Tap ........................... $
�
Slate Surcharge....... _ ....... Sewer Hook-upS
Penalty .............................. $ Water Hook-up$
Septic System .................... _.. $- Meter Hom.............. E—
.............
Other . ............................... It �- Water Meter.......................... S
Subtotal ....................... $ - Check if ']Sewer 6 Water Connection Fee.,..... 11
Deferred 'Water Tower Fee .....................5
This Appli Becomes Your Building Permit Whan
APProve Water Tap ............................ $
City Fee .............................. S
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By ate d Other . ............................... S
Certificate of Occupancy Total Due ...................... a.
Issued _ -_ Paid Receipt no. 1a u3 <)
Date - By
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24 Hour nonce for all mawuonn
4,174230 aso e.m. 10:03 am.
D TIME
CITY OF PRIOR LAKE CALLEOIN ]
INSPECTIO � 7CE SCH /
EDULED �_ �—
PE`.1MIT / /� /
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ADDRESS �( N` / r`� \ L' ` �y/
OWNER
CONTR.
TELEPHONE NO.
it
W 0 FOOTING CPLUMBING RI
OSTTE INSPECTION
w RAMING C MECHANICAL
O E%CAVAGRADINGIALUNG
0 INSULATION C WATER HOOKUP
❑ LAKESHORE/WETLANDS
C O WALL BD. C METER SETTTURN ON
0 COMPLAINT
Z O FINAL 0 SEWER HOOKUP
0 FOLLOW -UP
Q C PROGRESS 0 SEPTIC INSTALL.
0 SEPTIC FINAL
Z 0 DEMOL. 0 SEPTIC MAINT.
0 FIREPLACE
J 0 FIRE PREV. 0 PLUMBING FINAL
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0 CORRECT WORK AND PROCEED
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❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
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0 CORRECT UNS CONDITION WITHIN
HOURS. INSPECTOR WILL RETURN.
STOP ORDER P SPECTOR.
INSPECTION RE IRED. L O ARRANGE ACCESS.
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