HomeMy WebLinkAboutBuilding Permit 99-0192
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2. SITE ADDR7~ J ') /1 /7 7\U f\
I ~ L.::lJ (" llY3h A.~~~ lA- \. IL t-" l)
3. LEGAL DESCRIPTION ( 12. NO. OF ~RIES
LOT (!)'$ 'f - B~K ---DO PID 2~S - A1-{)O l( -()
AOOmON Ul6~ l~'~ I 'E- )ddn ' 13l;~\UCTlON
~R ~ame) ../ t JAddress) () (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
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5. ARCHITECT (N e) (Address) (Tel. No.)
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DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
118 2.Z \8
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
6. BUILDER (Name) (Address) ~ (Tel. No.)
& L ,I '2.2~/(.,. 331 Ave-
-.t.u~ W\ bJD'fItAL~,L-k'l>>U~ & W1~ "'^ J 6'1- "l 'i ~-~ 13
7. PE OF WORK Fireplace 0 Slptic LJ Dec~ Re-roofin~ Porch LJ
New Construction LJ Alterations 0 Addition 0 Finish Attic 0 Re-sidlngA Finish Basement LJ
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes
No
d 1, White File
fl- 1Y' 2. Pink 0..-
V~ /} 3, Yellow Applicant
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Permit No. q ~ I'-{ q2- -
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
(Depth)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COST~E
2S;~ .-
- 17. COMPLETION DATE
)--2-~99
I hereby certify that I have furnished infonnation 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
th mentioned property a 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
uilding 0 can revoke this it for' g. Furthermore, I hereby agree that the city Officirl t[2Ua designee ma. y enter upon the property to perform n~)tj i~ons.
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Signature se No. Date
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SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING 11s It{J<...
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee................................... $
MA I cRIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LJ
PILING LOGS LJ
PERCOLATION TESTS LJ
SETS
COPIES
PLANS & SPECS LJ
SURVEY 0
PLOT PLAN
o
Plan Check Fee .... ............. ............ $
State Su rcharge ............................. $
74 ~ 75
'.25
Amount Brought Forward . .... . .. .. .. .. .... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. .. . ... .. .. .. ..... $
Sewer Tap ................................... $
$
Pressure Reducer .. . .. .. .. .. .. .. . .. . ... .... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee .. .. . .. .. . .. .. . .. .. .. .. .... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7~.C(j
Paid lfa f&- Rece;ptNo. .3L/fl5Z
Date 3-1'2 -l[Gj By 4Ki 0
This Is to certify that the request In the above application and accompanying documents is In accordance with the City Zoning Ordinance a~d may proceed as r~ed. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compHance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City:
Penalty....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Pennlt ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
-
DATE TIME
~
CITY OF PRIOR LAKE
INSPECnON NOTICE
SCHEDULED
ADDRESS
~ 3;06
/(,/3/ ~.
OWNER
CONTR.
PHONE NO. . PERMIT NO.
D FOOTING 91-1,- D PLUMBING RI
o FOUNDATION '" 0 MECH RI
..)(FRAMING Poe.&l/ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~FINAL A.DOAl~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: 1r- 274- A-
o EXlGRADIFILLlNG
o COMP T
o CE RI"
FIREPLACE FINAL
o GASLlNE AIR tST
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~KSA~ISFA" v (.PROCEED
o CORRECT ACT N A PROCEED
o CORRECT 0 K CAL FOR REINSPECTION BEFORE COVERING
Inspector: OWner/Contr:
"-
447-9850 FOR' 'HE NEXT INSPECTION 24 HOURS IN ADVANCE.
ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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