HomeMy WebLinkAboutBuilding Permit 99-0189
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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ADDRESS \C:,esl PU~8Y'~ CtlV
OWNER CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FRAMING
o INSULATION ^
~FINAL r
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
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Owner/Contr:
Inspector:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
. t 991)
qq -I~
Permit No.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print 0' Type and sign at bottom)
2. SITE ADDRESS
1. DATE
.3/'81,~
f78-f2-E 6f2./t--JE: Ct~.
1. '7 - 2;;0 ~~ CYl_'tj ~ j
fONV~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
I {;J9J5 I
3. LEGAL DESCRIPTION
LOT l1--
t==\/LSr"
12. NO. OF STORIES
':7 PID
<..U~rBUp-'1
BLOCK
ADO ~,..,
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
t<D klc (
5. ARCHITECT
(Name)
G~
(Name)
(Address)
It, <is I ft""'ll.Etf.Id JI.Jt;' l!J1l SiV
(Address)
(Tel. No.)
'IV-a -?(),) 'I
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
t
Dec~
Finish Attir
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Re-roofing 0 Porch 0
Re.siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
17. COMPLETION DATE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
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
the a tioned7tilro rty, 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
I ding off' can ev t' r f,nnit foJ'ust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfonn neted 7?e;ons.
~ 31
, -,. Signature License No. . Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
Front
Back
Side
Side
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 7.,~f'\rJ. (f) C
riDe.
fHR
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
USE OF BUILDING
PLOT PLAN
o
<v
~ S U
(oL . (. S-
4c>. <{ 1
L. 19-0
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 II 4
Permit Fee ................................... $
Amount Brought Forward .................. $
Pal1< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
~~
J~
~
'0
Penalty ....................................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ '. - - T2-
Paid TC'lue ...................~;~~i~;~O~ ~~ ~_ t5
Date f/-I- 91 By
This is to certify th~.t~est in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
sig~. \~~rary Certifi~t.2..~~mPliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
v City Planner 3 Date Special Conditions n any
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennit ...................... $
::LJ4~....if'~e:itWhe~9JOv~.C;
BY~, ~ullalng~ate ~"'LCf~7 /
Certificate of Occu~~ -,
Issued
24 hour notice for all inspections 447-9850