HomeMy WebLinkAboutBuilding Permit 99-0280
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS S<Bqo
OWNER
PHONE NO.
o FOOTING
o FRAMING
~NSULATION 1\
FINAL n
OUNDATION
o DEMOLITION
o FIRE PREVo
DATE TIME
SCHEDULED c..t -I ~
IJ.-~ O~
if'
CONTR.
PERMIT NO.
~q -c.,&-{)
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
G FINAL
o SITE INSP ON
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
,
//
/'
/
'i WORK SATISFACTO~ROCEED
o CORRECT ACTION \N~ 'ROCEED
o CORRECT WORK, C;~ jR R INSPECTION BEFORE COVERING
Inspector: ('L Owner/Contr:
CALL "+23TR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REllf:JMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
MIf..BfCEIVEQ CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
., SBQo
';1;, I~q
, , ,
e.-
~IZ-.
HIOPf:J.J OAk..S c-//l....
3. LEGAL DESCRIPTION
LOT \~ BLOCK
~\'i>06J ()~
ADDITION
4. OWNER (Name)
~bl-l-e.t.Z-
5. ARCHITECT (Name)
6. BUILDER
(Name)
\4.u 4t i:OIofL.-S
7. TYPE OF WORK
New Construction 0
6JLl5T.
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
l
tz.s... 01 ~ Ac; rz. -0
PID
1. White
2. Pink
3. Yellow
File
City
Applicant
t~Ao()
(Address)
5'840 J.J.io.o{.IJ OI1C
(Address)
(Tel. No.)
cut. Sc..
(Tel. No.)
Permit No.
Qq.2f;o
(Address) (Tel. No.)
I,""O-LO s,. FtrZ.A...( GIS uJ
POlO{\.. tAu.. rl.0 5s~12.. .. #4--+' -I 93'L
Septic 0 Deck 0 Re-roofing)( Porch 0
Addition 0 Finish Attic 0 Re-siding 0 f ~nish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
dr tJOQ(J ~
17. COMPLETION DATE
4- J~- 97
I hereby certify that I 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a desi.~nee may enter upon the property to perform n~ inspections.
X r-~ 11_ ~... t: .,1; 'I . '200'-l7Jlir\\' . tJ.....IJ....."
., . alure License No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
J
f2lE5 A-1'i2-
11-
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
fl5C(). --
Division 1 2 3 4
Permit Fee ................................... $
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
"14-. '15""
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
$
City:
, . 2-S
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
....,,. .-
Total Due .............................. $ '''''
Paid "1 c,.- # Receipt No. ~ ~G4-
4-lb "T By (4) f.t .
This is to certify that the request in the above application and accompanying documents IS in accordance with the City Zoning Ordi^ance'and may proceed as requested. This document when
This Applicati
By
Certificate of Occupancy
Issued
Date
City Planner
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.
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850