HomeMy WebLinkAboutBuilding Permit 99-0241
CITY 6F PRIOR LAKE
.. INSPECTION NOTICE
SCHEDULED
DATE
4~s-qq
TIME
-.A,
ADDRESS 15704- li1o--'\.~
~
......
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~, Zq"
o FOOTING
o FRAMING
, ~~SULATIONft'
~~~NAL
o FOUNDA TIO
o DEMOLITION
o FIRE PREVo 0
~OMMENTS: <hco~
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 LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
0nL Gw~
I
It? I
\ /"'-- /
~ /
/ /
I
J r
~ SATISFACTORY, PROCEED
';; ~RECT ION PROCEED
o CORRECT INSPECTION BEFORE COVERING
, Owner/Contr:
HE NEXT INSPECTION 24 HOURS IN ADVANCE.,
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
MN\3t9S
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.Slr~1~~ H~1hlavr.J J1v-(? VLt)
3. LEGAL DESCRIPTION Z
LOT II BLOCK..I...-.. A i A
ADDITIONr~/(,L1/1 d V\ euJ I S;' .f1tJ'l..L L L-
Permit No. q q '-:l<{j
~l;~/qcf
(!. t sf) I I I
ex:) -I Lf?:>- D30- Q
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID
13. TYPE OF CONSTRUCTION
4. OWNER
~,'
I \ If\
5. ARCHITECT
(Name)
1 Gf <. f~ L<;ct\
(Name)
(Address) J
If-) 701) If,l~toVl(j
(Address)
/}H' r1J if )
(Tel. 447-&f)/1
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
(Address)
~ d~ JcJ ~ ~~~rr1l{JJ,y JO r JOt'\
7. TYPE OF WORK Fireplace Ll Septic Ll Deck Ll I Re-roofin~ Porch Ll
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJJ:fi;tOSTN ALUE
Chimney Ll Misc. .:$ ) 7 ~ _
:~~:~PERTY AREA OR ACRES :i:t~OPERTY DI~;~:'ONS ~:~ CULVER::'ZE ;; t;l;L;'ON DATE
I hereby certify~t1 av~e ished information on this application which is to the best of my knowledge true and correct. I also certify thai lam \he owner or authorized agent for
the abov e ~ e~~ t all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin n is for just cause. Furthermore, I hereby agree that the city official or a de~i9nee may enter upon the property to perfo"}l n~EljIed~ections.
X . ~ f '_: J In KO'1 . Jt3~/??
'- l...//'l ~nature License No. I Date
Cho\4s Dc)~-d1'\
GI'it 7Cj 91J/~
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
Ll ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING &S fl t(
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS Ll
PLANS & SPECS Ll
SURVEY Ll
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
,Ll .le;
( - '1~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn .................... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7(~ ~C)O
Paid je-, ~60 Receipt No. "f>L(F;'3 Lf
Issued Date ~ 1:\ Il1. 9 By n 1/..1 J \
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 requ~ument 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.
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Speciai Conditions n any
24 hour notice for all inspections 447-9850